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General NPI Number Information
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NPI Number | 1376772210
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Entity Type | Organization
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Legal Business Name | MACOMBER COUNSELING SERVICES, P.A., L.L.C.
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Dates
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Enumeration Date | 07/14/2009
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Last Update Date | 07/14/2009
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Provider Practice Location Address
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Address Line | 333 LINCOLN ST # 141
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City | SACO
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State | ME
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Zip | 04072-3113
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Country | US
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Telephone | 207-229-5354
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Fax | 207-510-7674
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Provider Business Mailing Address
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Address Line | 333 LINCOLN ST # 141
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City | SACO
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State | ME
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Zip | 04072-3113
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Country | US
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Telephone | 207-229-5354
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Fax | 207-510-7674
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. WILLIAM F MACOMBER JR.
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Credential | L.C.S.W.
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Telephone | 207-229-5354
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | LC7873
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License Number State | ME
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