Healthcare Provider Details

I. General information

NPI: 1366513897
Provider Name (Legal Business Name): ANXIETY SOLUTIONS OF NORTHERN NEW ENGLAND, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/13/2006
Last Update Date: 01/17/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

186 TWIN SPRING LANE
LINCOLN ME
04457
US

IV. Provider business mailing address

PO BOX 70
RAYMOND ME
04071-0070
US

V. Phone/Fax

Practice location:
  • Phone: 207-655-2737
  • Fax: 207-655-1065
Mailing address:
  • Phone: 207-655-2737
  • Fax: 207-655-1065

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State

VIII. Authorized Official

Name: DR. GORDON POWELL STREET
Title or Position: CO-OWNER AND BUSINESS MANAGER
Credential: PHD
Phone: 207-655-2737