Provider Demographics
NPI:1801003512
Name:SEARSPORT COUNSELING ASSOCIATES
Entity Type:Organization
Organization Name:SEARSPORT COUNSELING ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT, SUPERVISOR, COUNSELOR
Authorized Official - Prefix:MS
Authorized Official - First Name:ANN
Authorized Official - Middle Name:J
Authorized Official - Last Name:BARCLAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-338-9145
Mailing Address - Street 1:PO BOX 674
Mailing Address - Street 2:
Mailing Address - City:SEARSPORT
Mailing Address - State:ME
Mailing Address - Zip Code:04974-0674
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9 FIELD ST
Practice Address - Street 2:SUITE 206
Practice Address - City:BELFAST
Practice Address - State:ME
Practice Address - Zip Code:04915-6661
Practice Address - Country:US
Practice Address - Phone:207-338-9145
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME271081251B00000X
ME453758251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME1225058258OtherINDIVIDUAL NPI
ME1619065711OtherINDIVIDUAL NPI