Provider Demographics
NPI:1417225046
Name:BICKFORD, CARRIE BERNICE (LCSW)
Entity type:Individual
Prefix:MS
First Name:CARRIE
Middle Name:BERNICE
Last Name:BICKFORD
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:CARRIE
Other - Middle Name:B
Other - Last Name:LAKS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:166 CEDAR ST
Mailing Address - Street 2:
Mailing Address - City:ROCKLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04841-2305
Mailing Address - Country:US
Mailing Address - Phone:813-777-4683
Mailing Address - Fax:352-544-0722
Practice Address - Street 1:166 CEDAR ST
Practice Address - Street 2:
Practice Address - City:ROCKLAND
Practice Address - State:ME
Practice Address - Zip Code:04841-2305
Practice Address - Country:US
Practice Address - Phone:813-777-4683
Practice Address - Fax:352-544-0722
Is Sole Proprietor?:No
Enumeration Date:2011-12-10
Last Update Date:2018-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW69871041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical