Provider Demographics
NPI:1992224448
Name:OVERCASH, ELISE (MA, LMFT)
Entity type:Individual
Prefix:
First Name:ELISE
Middle Name:
Last Name:OVERCASH
Suffix:
Gender:F
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:89 CLAPBOARD RD
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04103-2246
Mailing Address - Country:US
Mailing Address - Phone:207-367-1414
Mailing Address - Fax:
Practice Address - Street 1:844 STEVENS AVE STE 33
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04103-2676
Practice Address - Country:US
Practice Address - Phone:207-367-1414
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-15
Last Update Date:2025-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
MEMF7484106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101Y00000XBehavioral Health & Social Service ProvidersCounselor