| Andrew Berglund, Lcsw, Llc | |
|
69 Federal St Portland ME 04101-4260 | |
| (207) 712-4711 | |
| (207) 772-7702 |
| Full Name | Andrew Berglund, Lcsw, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 69 Federal St, Portland, Maine |
| Authorized Official Name and Position | Andrew N Berglund (OWNER) |
| Authorized Official Contact | 2077124711 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Andrew Berglund, Lcsw, Llc 69 Federal St Portland ME 04101-4260 Ph: (207) 712-4711 | Andrew Berglund, Lcsw, Llc 69 Federal St Portland ME 04101-4260 Ph: (207) 712-4711 |
| NPI Number | 1659686988 |
|---|---|
| Provider Enumeration Date | 08/11/2010 |
| Last Update Date | 08/11/2010 |
| Medicare PECOS PAC ID | 6800911173 |
|---|---|
| Medicare Enrollment ID | O20100910000578 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659686988 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | LC6069 (Maine) | Primary |
| Provider Name | Andrew N Berglund |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1386747970 PECOS PAC ID: 6507818614 Enrollment ID: I20050217000223 |
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