=====================================================
General NPI Number Information
=====================================================
NPI Number | 1760341085
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | GBA COUNSELING SERVICES PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/21/2026
-----------------------------------------------------
Last Update Date | 01/22/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 511 WING RD
-----------------------------------------------------
City | HERMON
-----------------------------------------------------
State | ME
-----------------------------------------------------
Zip | 04401-0422
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 207-200-3251
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 158
-----------------------------------------------------
City | LEVANT
-----------------------------------------------------
State | ME
-----------------------------------------------------
Zip | 04456-0158
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 207-200-3251
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | EXECUTIVE DIRECTOR /CLINICIAN
-----------------------------------------------------
Name | ROBIN L SANDAU
-----------------------------------------------------
Credential | LCPC
-----------------------------------------------------
Telephone | 207-631-1247
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YA0400X
-----------------------------------------------------
Taxonomy Name | Addiction (Substance Use Disorder) Counselor
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 101YM0800X
-----------------------------------------------------
Taxonomy Name | Mental Health Counselor
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 251S00000X
-----------------------------------------------------
Taxonomy Name | Community/Behavioral Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------