Individual provider · Type 1 NPI
R. Andrew Derstine, LCSW
Mental Health Counselor · Bridgton, ME
NPI number
1114051984
Active
Practice location
236A Portland Rd
Bridgton, ME 04009
Fax (207) 647-2400
Mailing address
PO Box 731
Bridgton, ME 04009
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Mental Health Counselor Primary | 101YM0800X | None listed |
Mental Health Counselor: Definition to come...
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About NPI 1114051984
R. Andrew Derstine, LCSW's National Provider Identifier is 1114051984, issued on Mar 15, 2007. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Bridgton, ME. The record was last updated on Nov 4, 2008.