Healthcare Provider Details
I. General information
NPI: 1265409528
Provider Name (Legal Business Name): CENTRAL MAINE COUNSELING SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/07/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
276 MAIN ST
LEWISTON ME
04240-7024
US
IV. Provider business mailing address
276 MAIN ST
LEWISTON ME
04240-7024
US
V. Phone/Fax
- Phone: 207-782-3386
- Fax: 207-782-3386
- Phone: 207-782-3386
- Fax: 207-782-3386
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YA0400X |
| Taxonomy | Addiction (Substance Use Disorder) Counselor |
| License Number | 272021 |
| License Number State | ME |
VIII. Authorized Official
Name: MS.
JEAN
ELIZABETH
LITCHFIELD
Title or Position: PRESIDENT
Credential: LCPC/LADC
Phone: 207-782-3386