=====================================================
General NPI Number Information
=====================================================
NPI Number | 1942867676
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | AT THE HELM COUNSELING AND CASE MANAGEMENT, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/29/2019
-----------------------------------------------------
Last Update Date | 05/29/2019
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 64 PARIS ST
-----------------------------------------------------
City | NORWAY
-----------------------------------------------------
State | ME
-----------------------------------------------------
Zip | 04268-5634
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 207-653-9349
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 32
-----------------------------------------------------
City | RAYMOND
-----------------------------------------------------
State | ME
-----------------------------------------------------
Zip | 04071-0032
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | EXECUTIVE DIRECTOR
-----------------------------------------------------
Name | SARAH M MILDRUM
-----------------------------------------------------
Credential | LCSW
-----------------------------------------------------
Telephone | 207-653-9349
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251S00000X
-----------------------------------------------------
Taxonomy Name | Community/Behavioral Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------