MEDICARE: CLINICAL COUNSELING ASSOCIATES OF MAINE, P.A.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	103TF0200X	Forensic Psychologist
2	106H00000X	Marriage & Family Therapist
3	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1629233663
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CLINICAL COUNSELING ASSOCIATES OF MAINE, P.A.

Provider Business Mailing Address
First Line	:	1863 WASHINGTON AVE
Second Line	:
City	:	PORTLAND
State	:	ME
Zip	:	04103-1625
Country	:	US
Telephone Number	:	207-797-7900
Fax Number	:	207-797-2966

Provider Business Practice Location Address
First Line	:	1863 WASHINGTON AVE
Second Line	:
City	:	PORTLAND
State	:	ME
Zip	:	04103-1625
Country	:	US
Telephone Number	:	207-797-7900
Fax Number	:	207-797-2966

Authorized Official
Title or Position	:	PRESIDENT
Name	:	H. MICHAEL ALPREN
Credential	:	J.D., M.S.
Telephone Number	:	207-797-0110

Provider Enumeration Date	:	07/18/2008
Last Update Date	:	07/18/2008

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