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General NPI Number Information
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NPI Number | 1144694894
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Entity Type | Individual
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Provider Name | HOWLAND W BICKERSTAFF LCPC, LADC, CCS
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Gender | Male
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Dates
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Enumeration Date | 11/18/2015
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Last Update Date | 11/18/2015
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Provider Practice Location Address
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Address Line | 86 TANDBERG TRL
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City | WINDHAM
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State | ME
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Zip | 04062-5841
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Country | US
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Telephone | 207-893-0386
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Fax | 207-893-2086
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Provider Business Mailing Address
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Address Line | PO BOX 1360
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City | WINDHAM
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State | ME
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Zip | 04062-1360
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Country | US
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Telephone | 207-893-0386
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Fax | 207-893-2086
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | CCS3597
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License Number State | ME
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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | LC1454
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License Number State | ME
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Taxonomy #3
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | CC1511
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License Number State | ME
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