Healthcare Provider Details

I. General information

NPI: 1699904102
Provider Name (Legal Business Name): PATRICK S MCFARLANE PMHNP, LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/06/2009
Last Update Date: 04/16/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

895 UNION ST SUITE 12
BANGOR ME
04401-3053
US

IV. Provider business mailing address

43 WHITING HILL RD SUITE 300
BREWER ME
04412-1005
US

V. Phone/Fax

Practice location:
  • Phone: 207-973-7979
  • Fax: 207-947-9579
Mailing address:
  • Phone: 207-973-5035
  • Fax: 207-973-5042

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberCNP131095
License Number StateME
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLC12020
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: