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NPI Code Detail

MEDICARE: MAKYLEE CHAN MHRT-C, CADC

MEDICARE: MAKYLEE CHAN MHRT-C, CADC
Medicare Provider Information

Scope of Practice

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

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) CounselorCAC9042ME

General Provider Information

NPI Number : 1912706201
Entity Type Code : Individual
Provider Name (Legal Business Name) : MAKYLEE CHAN MHRT-C, CADC
Provider Business Mailing Address
First Line : 76 HURRICANE RD
Second Line :
City : FALMOUTH
State : ME
Zip : 04105-2524
Country : US
Telephone Number : 207-595-5375
Fax Number :
Provider Business Practice Location Address
First Line : 103 PARK ST
Second Line :
City : LEWISTON
State : ME
Zip : 04240-7203
Country : US
Telephone Number : 207-440-7922
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/10/2025
Last Update Date : 03/10/2025

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