Provider Demographics
NPI: | 1871863753 |
---|---|
Name: | CRAIN & LAWRENCE P.A. |
Entity Type: | Organization |
Organization Name: | CRAIN & LAWRENCE P.A. |
Other - Org Name: | MAINE STREET COUNSELING SERVICES AND CENTER |
Other - Org Type: | Doing Business As |
Authorized Official - Title/Position: | PRESIDENT |
Authorized Official - Prefix: | |
Authorized Official - First Name: | WILLIAM |
Authorized Official - Middle Name: | E |
Authorized Official - Last Name: | CRAIN |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 207-688-4494 |
Mailing Address - Street 1: | 209 CHADSEY RD |
Mailing Address - Street 2: | |
Mailing Address - City: | POWNAL |
Mailing Address - State: | ME |
Mailing Address - Zip Code: | 04069-6054 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 207-688-4494 |
Mailing Address - Fax: | 207-688-6515 |
Practice Address - Street 1: | 209 CHADSEY RD |
Practice Address - Street 2: | |
Practice Address - City: | POWNAL |
Practice Address - State: | ME |
Practice Address - Zip Code: | 04069-6054 |
Practice Address - Country: | US |
Practice Address - Phone: | 207-688-4494 |
Practice Address - Fax: | 207-688-6515 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2012-01-09 |
Last Update Date: | 2012-11-26 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 101YM0800X | Behavioral Health & Social Service Providers | Counselor | Mental Health | Group - Single Specialty |