Healthcare Provider Details

I. General information

NPI: 1174851042
Provider Name (Legal Business Name): PATHWAYS OF MAINE, LLC DBA CLARVIDA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/03/2009
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 BOWDOIN MILL IS STE 304
TOPSHAM ME
04086-1265
US

IV. Provider business mailing address

513 PRINCE EDWARD ST STE 101
FREDERICKSBURG VA
22401-5790
US

V. Phone/Fax

Practice location:
  • Phone: 207-373-0620
  • Fax: 207-373-0628
Mailing address:
  • Phone: 540-710-2800
  • Fax: 540-710-7447

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number392123
License Number StateME

VIII. Authorized Official

Name: MS. NICOLE T ZENGA
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 207-373-0620