Individual provider · Type 1 NPI

Peter J. Fuller, LCSW, LADC

Clinical Social Worker · Springvale, ME

NPI number 1659652022 Active

Practice location

474 Main St
Springvale, ME 04083-1409

Call (207) 324-1500 Map

Fax (207) 490-5263

Mailing address

78 Atlantic Place
South Portland, ME 04106-2316

Specialties and licenses

TaxonomyCodeLicense
Clinical Social Worker Primary 1041C0700XLC4929 (ME)
Addiction (Substance Use Disorder) Counselor 101YA0400XLC4294 (ME)

Clinical Social Worker: A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpers…

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About NPI 1659652022

Peter J. Fuller, LCSW, LADC's National Provider Identifier is 1659652022, issued on Aug 30, 2011. The primary taxonomy on file is Clinical Social Worker (1041C0700X), and the practice location is in Springvale, ME. The record was last updated on Jun 22, 2016.