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General NPI Number Information
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NPI Number | 1326093295
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Entity Type | Individual
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Provider Name | MR. DAVID MATTHEWS MCCAIN
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Gender | Male
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Dates
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Enumeration Date | 05/22/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 650 MAIN ST SUITE 103
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City | SOUTH PORTLAND
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State | ME
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Zip | 04106-5448
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Country | US
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Telephone | 207-774-4564
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Fax |
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Provider Business Mailing Address
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Address Line | 63A WILSON ST
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City | PORTLAND
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State | ME
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Zip | 04101-4448
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Country | US
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Telephone | 207-771-8833
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Fax |
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | CC1755
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License Number State | ME
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