Provider Demographics
NPI:1386411775
Name:LOUISON-SEMROW, MAX JAMES (LCSW / LICSW)
Entity type:Individual
Prefix:
First Name:MAX
Middle Name:JAMES
Last Name:LOUISON-SEMROW
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 1:144 US ROUTE 1
Mailing Address - Street 2:
Mailing Address - City:SCARBOROUGH
Mailing Address - State:ME
Mailing Address - Zip Code:04074-7219
Mailing Address - Country:US
Mailing Address - Phone:207-396-7606
Mailing Address - Fax:207-819-6802
Practice Address - Street 1:144 US ROUTE 1
Practice Address - Street 2:
Practice Address - City:SCARBOROUGH
Practice Address - State:ME
Practice Address - Zip Code:04074-7219
Practice Address - Country:US
Practice Address - Phone:207-396-7606
Practice Address - Fax:207-819-6802
Is Sole Proprietor?:No
Enumeration Date:2023-12-06
Last Update Date:2024-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELC220781041C0700X
MALICSW1261041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical