Healthcare Provider Details

I. General information

NPI: 1255162913
Provider Name (Legal Business Name): DOWN EAST MENTAL HEALTH COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/13/2024
Last Update Date: 09/16/2024
Certification Date: 09/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

567 MAIN ST
EAST MACHIAS ME
04630
US

IV. Provider business mailing address

PO BOX 8
EAST MACHIAS ME
04630-0008
US

V. Phone/Fax

Practice location:
  • Phone: 207-726-8474
  • Fax: 888-518-2282
Mailing address:
  • Phone: 207-726-8474
  • Fax: 888-518-2282

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: MATTHEW W HALL
Title or Position: COUNSELOR
Credential: LCPC
Phone: 207-726-8474