Provider Demographics
NPI:1851892442
Name:AUSTIN, ALISHIA M (CADC)
Entity Type:Individual
Prefix:
First Name:ALISHIA
Middle Name:M
Last Name:AUSTIN
Suffix:
Gender:F
Credentials:CADC
Other - Prefix:
Other - First Name:ALISHIA
Other - Middle Name:M
Other - Last Name:MICLON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CADC
Mailing Address - Street 1:DISCOVERY HOUSE CTC WATERVILLE 40 AIRPORT RD
Mailing Address - Street 2:
Mailing Address - City:WATERVILLE
Mailing Address - State:ME
Mailing Address - Zip Code:04901
Mailing Address - Country:US
Mailing Address - Phone:207-872-7272
Mailing Address - Fax:207-873-0639
Practice Address - Street 1:DISCOVERY HOUSE CTC WATERVILLE 40 AIRPORT RD
Practice Address - Street 2:
Practice Address - City:WATERVILLE
Practice Address - State:ME
Practice Address - Zip Code:04901
Practice Address - Country:US
Practice Address - Phone:207-872-7272
Practice Address - Fax:207-873-0639
Is Sole Proprietor?:No
Enumeration Date:2018-02-28
Last Update Date:2018-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECAC6249101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)