Provider Demographics
NPI:1073653358
Name:YAHR, GREGGUS WINER (PHD, NCSP)
Entity Type:Individual
Prefix:DR
First Name:GREGGUS
Middle Name:WINER
Last Name:YAHR
Suffix:
Gender:M
Credentials:PHD, NCSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 BUCKNAM RD
Mailing Address - Street 2:SUITE 1G
Mailing Address - City:FALMOUTH
Mailing Address - State:ME
Mailing Address - Zip Code:04105-1208
Mailing Address - Country:US
Mailing Address - Phone:207-781-1572
Mailing Address - Fax:207-781-1593
Practice Address - Street 1:5 BUCKNAM RD
Practice Address - Street 2:SUITE 1G
Practice Address - City:FALMOUTH
Practice Address - State:ME
Practice Address - Zip Code:04105-1208
Practice Address - Country:US
Practice Address - Phone:207-781-1572
Practice Address - Fax:207-781-1593
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-07
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECC2294101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME465146OtherTUFTS
ME047463OtherANTHEM ID