Healthcare Provider Details
I. General information
NPI: 1780925826
Provider Name (Legal Business Name): ANGELICA R MCADAM-KING CADC
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 03/14/2013
Last Update Date: 04/13/2026
Certification Date: 04/13/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
162 MAIN ST
PRESQUE ISLE ME
04769-2817
US
IV. Provider business mailing address
172 ACADEMY ST
PRESQUE ISLE ME
04769-3165
US
V. Phone/Fax
- Phone: 207-768-3304
- Fax: 207-764-6340
- Phone: 207-540-1522
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1041C0700X |
| Taxonomy | Clinical Social Worker |
| License Number | LC23974 |
| License Number State | ME |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 1041C0700X |
| Taxonomy | Clinical Social Worker |
| License Number | LICSW1143350 |
| License Number State | MA |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101YA0400X |
| Taxonomy | Addiction (Substance Use Disorder) Counselor |
| License Number | |
| License Number State | ME |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: