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General NPI Number Information
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NPI Number | 1649105750
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Entity Type | Organization
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Legal Business Name | NORTH STAR KAPWA COUNSELING
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Dates
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Enumeration Date | 06/17/2026
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Last Update Date | 06/17/2026
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Provider Practice Location Address
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Address Line | 389 W RIVER RD
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City | AUGUSTA
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State | ME
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Zip | 04330-8144
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Country | US
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Telephone | 207-200-6147
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Fax | 207-200-3866
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Provider Business Mailing Address
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Address Line | 14 CROSSING WAY SUITE 3 #1047
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City | AUGUSTA
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State | ME
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Zip | 04330
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Country | US
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Telephone | 207-200-6147
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Fax | 207-200-3866
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Authorized Official
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Title or Position | PSYCHOLOGIST
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Name | KEVIN PACIFICO TAPP GONZAGA
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Credential | PHD
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Telephone | 207-200-6147
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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