Provider Demographics
NPI:1366752271
Name:CAVER, CHRISTINA MARIE (LCSW)
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:MARIE
Last Name:CAVER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:276 WHITTEN ROAD
Mailing Address - Street 2:SUITE 2
Mailing Address - City:HALLOWELL
Mailing Address - State:ME
Mailing Address - Zip Code:04347
Mailing Address - Country:US
Mailing Address - Phone:207-621-6760
Mailing Address - Fax:
Practice Address - Street 1:21 MAIN ST STE 301
Practice Address - Street 2:
Practice Address - City:BANGOR
Practice Address - State:ME
Practice Address - Zip Code:04401-6359
Practice Address - Country:US
Practice Address - Phone:207-631-2201
Practice Address - Fax:207-631-2203
Is Sole Proprietor?:No
Enumeration Date:2010-10-13
Last Update Date:2019-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEMC12782104100000X
MELC138761041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker