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General NPI Number Information
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NPI Number | 1952360760
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Entity Type | Organization
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Legal Business Name | TRANSITIONS COUNSELING, INC.
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Dates
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Enumeration Date | 03/21/2006
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Last Update Date | 12/01/2008
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Provider Practice Location Address
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Address Line | 583 FOREST AVE
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City | PORTLAND
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State | ME
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Zip | 04101-1547
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Country | US
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Telephone | 207-773-8886
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Fax | 207-773-8887
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Provider Business Mailing Address
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Address Line | 583 FOREST AVE
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City | PORTLAND
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State | ME
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Zip | 04101-1547
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Country | US
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Telephone | 207-773-8886
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Fax | 207-773-8887
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Authorized Official
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Title or Position | CEO/PRESIDENT
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Name | KELLI STAR FOX
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Credential | LCSW, LADC, CCS
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Telephone | 207-773-8886
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number | 246645
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License Number State | ME
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Taxonomy #2
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number | 411170
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License Number State | ME
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