Provider Demographics
NPI:1053112862
Name:BOCAL, ELISABELLE LE (LCSW)
Entity type:Individual
Prefix:
First Name:ELISABELLE
Middle Name:LE
Last Name:BOCAL
Suffix:
Gender:
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 LASSELL ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04102-2610
Mailing Address - Country:US
Mailing Address - Phone:207-409-0989
Mailing Address - Fax:
Practice Address - Street 1:5 STEWART DR
Practice Address - Street 2:
Practice Address - City:SCARBOROUGH
Practice Address - State:ME
Practice Address - Zip Code:04074-2027
Practice Address - Country:US
Practice Address - Phone:207-303-0061
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-19
Last Update Date:2025-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical