Provider Demographics
NPI:1730495094
Name:CHRISTOPHER AARON COUNSELING CENTER
Entity Type:Organization
Organization Name:CHRISTOPHER AARON COUNSELING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LAWRENCE
Authorized Official - Middle Name:
Authorized Official - Last Name:LEEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:207-657-7700
Mailing Address - Street 1:67 SHAKER RD
Mailing Address - Street 2:STE. 7
Mailing Address - City:GRAY
Mailing Address - State:ME
Mailing Address - Zip Code:04039-9640
Mailing Address - Country:US
Mailing Address - Phone:207-657-7700
Mailing Address - Fax:207-657-7770
Practice Address - Street 1:67 SHAKER RD
Practice Address - Street 2:STE. 7
Practice Address - City:GRAY
Practice Address - State:ME
Practice Address - Zip Code:04039-9640
Practice Address - Country:US
Practice Address - Phone:207-657-7700
Practice Address - Fax:207-657-7770
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-25
Last Update Date:2010-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME484520104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME434273200Medicaid
ME432373800Medicaid