Healthcare Provider Details

I. General information

NPI: 1326531971
Provider Name (Legal Business Name): CARSTEN MACKELDEY
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/08/2018
Last Update Date: 03/24/2026
Certification Date: 03/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11 BACK RD
PLEASANT POINT ME
04667-4119
US

IV. Provider business mailing address

11 BACK RD
PLEASANT POINT ME
04667-4119
US

V. Phone/Fax

Practice location:
  • Phone: 207-853-0644
  • Fax: 207-853-6230
Mailing address:
  • Phone: 207-853-0644
  • Fax: 207-853-6230

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberLC7021
License Number StateME
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLC21635
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: