Provider Demographics
NPI:1881986032
Name:PRESCOTT, DAVID S (LCSW, LICSW)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:S
Last Name:PRESCOTT
Suffix:
Gender:M
Credentials:LCSW, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:820 MAIN STREET
Mailing Address - Street 2:SUITE 300
Mailing Address - City:WESTBROOK
Mailing Address - State:ME
Mailing Address - Zip Code:04092
Mailing Address - Country:US
Mailing Address - Phone:207-854-1030
Mailing Address - Fax:207-854-1001
Practice Address - Street 1:820 MAIN STREET
Practice Address - Street 2:SUITE 300
Practice Address - City:WESTBROOK
Practice Address - State:ME
Practice Address - Zip Code:04092
Practice Address - Country:US
Practice Address - Phone:207-854-1030
Practice Address - Fax:207-854-1001
Is Sole Proprietor?:No
Enumeration Date:2011-05-06
Last Update Date:2011-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELC12700104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker