Provider Demographics
NPI:1184848509
Name:HOWLAND W. BICKERSTAFF
Entity Type:Organization
Organization Name:HOWLAND W. BICKERSTAFF
Other - Org Name:NONE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:HOWLAND
Authorized Official - Middle Name:W
Authorized Official - Last Name:BICKERSTAFF
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC, LADC, CCS
Authorized Official - Phone:207-831-3328
Mailing Address - Street 1:46 LINNELL RD
Mailing Address - Street 2:
Mailing Address - City:WINDHAM
Mailing Address - State:ME
Mailing Address - Zip Code:04062-5701
Mailing Address - Country:US
Mailing Address - Phone:207-831-3328
Mailing Address - Fax:207-591-4521
Practice Address - Street 1:DANZIG COUNSELING SERVICES, 936 ROOSEVELT TRAIL
Practice Address - Street 2:
Practice Address - City:WINDHAM
Practice Address - State:ME
Practice Address - Zip Code:04062
Practice Address - Country:US
Practice Address - Phone:207-831-3328
Practice Address - Fax:207-591-4521
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELC 1454101YA0400X
MECC 1511101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty