Healthcare Provider Details

I. General information

NPI: 1184848509
Provider Name (Legal Business Name): HOWLAND W. BICKERSTAFF
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/13/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

DANZIG COUNSELING SERVICES, 936 ROOSEVELT TRAIL
WINDHAM ME
04062
US

IV. Provider business mailing address

46 LINNELL RD
WINDHAM ME
04062-5701
US

V. Phone/Fax

Practice location:
  • Phone: 207-831-3328
  • Fax: 207-591-4521
Mailing address:
  • Phone: 207-831-3328
  • Fax: 207-591-4521

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberLC 1454
License Number StateME
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberCC 1511
License Number StateME

VIII. Authorized Official

Name: HOWLAND W. BICKERSTAFF
Title or Position: THERAPIST
Credential: LCPC, LADC, CCS
Phone: 207-831-3328