Healthcare Provider Details

I. General information

NPI: 1750285623
Provider Name (Legal Business Name): BE FREE ADDICTION COUNSELING SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/05/2026
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

219 ROOSEVELT TRL
WINDHAM ME
04062-4396
US

IV. Provider business mailing address

219 ROOSEVELT TRL
WINDHAM ME
04062-4396
US

V. Phone/Fax

Practice location:
  • Phone: 207-310-8942
  • Fax:
Mailing address:
  • Phone: 207-310-8942
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number StateNULL

VIII. Authorized Official

Name: PHYLLIS WARCHOL
Title or Position: OWNER
Credential: LADC,CCS,MHRT-C
Phone: 207-310-8942