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Samantha Blackadar, LCSW, LICSW

Social Worker, Clinical in South Portland, ME. Individual provider (NPI-1).

NPI number1164068128
StatusActive
Last updated in NPPESNov 25, 2019

Details

NPI
1164068128
Entity type
Individual (NPI-1)
Name
Samantha Blackadar
Credential
LCSW, LICSW
Sex
Female
Sole proprietor
Yes
Enumeration date
Nov 25, 2019
Last updated
Nov 25, 2019

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
1041C0700X Social Worker, ClinicalLC18385–Yes

Practice location

100 Gannett Dr
South Portland, ME 04106-5900

Phone 207-854-1030

Mailing address

46 Evans Road
Bridgton, ME 04009

Phone 603-969-5317

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