Provider Demographics
NPI:1912069972
Name:GABEL-RICHARDS, ANDREA (LCSW)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:
Last Name:GABEL-RICHARDS
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 1:424 LAMOINE BEACH RD
Mailing Address - Street 2:
Mailing Address - City:LAMOINE
Mailing Address - State:ME
Mailing Address - Zip Code:04605-4644
Mailing Address - Country:US
Mailing Address - Phone:207-667-3132
Mailing Address - Fax:
Practice Address - Street 1:210 MAIN ST
Practice Address - Street 2:
Practice Address - City:ELLSWORTH
Practice Address - State:ME
Practice Address - Zip Code:04605-1949
Practice Address - Country:US
Practice Address - Phone:207-667-8670
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME000010821041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MEA009630OtherHARVARD PILGRIM HEALTH CA
ME017446OtherBLUE CROSS BLUE SHIELD