Provider Demographics
NPI:1821775321
Name:INTEGRATIVE PSYCHIATRY OF MAINE
Entity Type:Organization
Organization Name:INTEGRATIVE PSYCHIATRY OF MAINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MISS
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:SILLARS
Authorized Official - Suffix:
Authorized Official - Credentials:AMHNP-BC
Authorized Official - Phone:207-205-5212
Mailing Address - Street 1:PO BOX 151
Mailing Address - Street 2:
Mailing Address - City:SACO
Mailing Address - State:ME
Mailing Address - Zip Code:04072-0151
Mailing Address - Country:US
Mailing Address - Phone:207-205-5212
Mailing Address - Fax:207-772-1629
Practice Address - Street 1:35 STOCKMAN AVE
Practice Address - Street 2:
Practice Address - City:SACO
Practice Address - State:ME
Practice Address - Zip Code:04072-1638
Practice Address - Country:US
Practice Address - Phone:207-205-5212
Practice Address - Fax:207-772-1629
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-28
Last Update Date:2023-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty