Healthcare Provider Details

I. General information

NPI: 1629243985
Provider Name (Legal Business Name): CUMLER COUNSELING & MEDICATION MANAGEMENT SERVICES, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/28/2008
Last Update Date: 04/28/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

52 WATER ST
HALLOWELL ME
04347-1437
US

IV. Provider business mailing address

PO BOX 262
EAST WINTHROP ME
04343-0262
US

V. Phone/Fax

Practice location:
  • Phone: 207-620-7196
  • Fax: 207-620-7198
Mailing address:
  • Phone: 207-395-4869
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License NumberR019740
License Number StateME

VIII. Authorized Official

Name: RUTH ELIZABETH CUMLER
Title or Position: PRESIDENT
Credential: APRN-BC, CNS, NP
Phone: 207-395-4869