Provider Demographics
NPI:1629233663
Name:CLINICAL COUNSELING ASSOCIATES OF MAINE, P.A.
Entity Type:Organization
Organization Name:CLINICAL COUNSELING ASSOCIATES OF MAINE, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:H. MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:ALPREN
Authorized Official - Suffix:
Authorized Official - Credentials:JD, MS
Authorized Official - Phone:207-797-0110
Mailing Address - Street 1:1863 WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04103-1625
Mailing Address - Country:US
Mailing Address - Phone:207-797-7900
Mailing Address - Fax:207-797-2966
Practice Address - Street 1:1863 WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04103-1625
Practice Address - Country:US
Practice Address - Phone:207-797-7900
Practice Address - Fax:207-797-2966
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-18
Last Update Date:2008-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
No103TF0200XBehavioral Health & Social Service ProvidersPsychologistForensicGroup - Single Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty