MS. MARINA D EDDY LICSW NPI 1417019274

NPI Information

NPI: 1417019274
Provider Name: MS. MARINA D EDDY, LICSW
Classification: Counselor - 101YA0400X
Entity Type: Individual

Specialization: Addiction (Substance Use Disorder)

Address:
17 BRIARWOOD LN
PORTLAND, ME
ZIP 04103
Phone: (207) 233-5778
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MS. Marina D Eddy, LICSW is an addiction (substance use disorder) counselor in Portland, ME. MS. Marina D Eddy, LICSW NPI is 1417019274. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

17 BRIARWOOD LN
PORTLAND, ME
ZIP 04103-775
Phone: (207) 233-5778

The enumeration date for this NPI number is 12/15/2006 and was last updated on 7/8/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YA0400X	Counselor	Addiction (Substance Use Disorder)	CADC CAC2971	MAINE	Yes
2	1041C0700X	Social Worker	Clinical	LICSW 113669	MASSACHUSETTS	X
3	1041C0700X	Social Worker	Clinical	LCSW LC7299	MAINE	X

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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