Healthcare Provider Details

I. General information

NPI: 1427002138
Provider Name (Legal Business Name): NORTHEAST OCCUPATIONAL EXCHANGE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/19/2006
Last Update Date: 08/23/2023
Certification Date: 08/23/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

444 STILLWATER AVE STE 210
BANGOR ME
04401-3500
US

IV. Provider business mailing address

PO BOX 1189
BANGOR ME
04402-1189
US

V. Phone/Fax

Practice location:
  • Phone: 207-942-3816
  • Fax: 207-561-4725
Mailing address:
  • Phone: 207-942-3816
  • Fax: 207-561-4725

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number238746
License Number StateME
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number230301
License Number StateME
# 3
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number230301
License Number StateME
# 4
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number230301
License Number StateME
# 5
Primary TaxonomyN
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number230301
License Number StateME
# 6
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number230301
License Number StateME
# 7
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number230301
License Number StateME

VIII. Authorized Official

Name: KATE FLANDERS
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 207-942-3816