Provider Demographics
NPI:1932270162
Name:BROPHY, CONTESSA L (LCSW-CC)
Entity Type:Individual
Prefix:MS
First Name:CONTESSA
Middle Name:L
Last Name:BROPHY
Suffix:
Gender:F
Credentials:LCSW-CC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 WAYMAN LN
Mailing Address - Street 2:MOUNT DESERT ISLAND HOSPITAL ORGANIZATION
Mailing Address - City:BAR HARBOR
Mailing Address - State:ME
Mailing Address - Zip Code:04609-1625
Mailing Address - Country:US
Mailing Address - Phone:207-288-5081
Mailing Address - Fax:207-288-7024
Practice Address - Street 1:322 MAIN ST
Practice Address - Street 2:MOUNT DESERT ISLAND HOSPITAL ORGANIZATION
Practice Address - City:BAR HARBOR
Practice Address - State:ME
Practice Address - Zip Code:04609-1648
Practice Address - Country:US
Practice Address - Phone:207-288-5081
Practice Address - Fax:207-288-7024
Is Sole Proprietor?:No
Enumeration Date:2006-11-10
Last Update Date:2008-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELC111561041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MELC11156OtherLICENSE
MEOTH000Medicare UPIN