Provider Demographics
NPI:1912051665
Name:SIROIS, ANNE M (LCSW)
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:M
Last Name:SIROIS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:390 MAIN ST
Mailing Address - Street 2:APT 3
Mailing Address - City:BIDDEFORD
Mailing Address - State:ME
Mailing Address - Zip Code:04005-2272
Mailing Address - Country:US
Mailing Address - Phone:207-467-5616
Mailing Address - Fax:
Practice Address - Street 1:390 MAIN ST
Practice Address - Street 2:APT 3
Practice Address - City:BIDDEFORD
Practice Address - State:ME
Practice Address - Zip Code:04005-2272
Practice Address - Country:US
Practice Address - Phone:207-467-5616
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-22
Last Update Date:2020-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELC40641041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME432366099Medicaid
MEME2359Medicare PIN