CATHOLIC CHARITIES MAINE

Provider Demographics

• NPI: 1013955947
• Name: CATHOLIC CHARITIES MAINE
• Entity type: Organization
• Organization Name: CATHOLIC CHARITIES MAINE
• Authorized Official - Title/Position: CONTRACTER
• Authorized Official - First Name: LAURIE
• Authorized Official - Middle Name: A
• Authorized Official - Last Name: SCOTT
• Authorized Official - Phone: 207-781-8550
• Mailing Address - Street 1: PO BOX 10660
• Mailing Address - City: PORTLAND
• Mailing Address - State: ME
• Mailing Address - Zip Code: 04104-6060
• Mailing Address - Country: US
• Mailing Address - Phone: 207-781-8550
• Mailing Address - Fax: 207-781-8560
• Practice Address - Street 1: 307 CONGRESS STREET
• Practice Address - City: PORTLAND
• Practice Address - State: ME
• Practice Address - Zip Code: 04101-3638
• Practice Address - Country: US
• Practice Address - Phone: 207-781-8550
• Practice Address - Fax: 207-781-8560
• EIN: <UNAVAIL>
• Is Organization Subpart?: No
• Enumeration Date: 2006-06-03
• Last Update Date: 2010-11-29

Provider Taxonomies

Primary?	Code	Type	Classification	Specialization	Group
Yes	1041C0700X	Behavioral Health & Social Service Providers	Social Worker	Clinical	Group - Multi-Specialty
No	101YM0800X	Behavioral Health & Social Service Providers	Counselor	Mental Health	Group - Multi-Specialty
No	1223G0001X	Dental Providers	Dentist	General Practice	Group - Multi-Specialty
No	124Q00000X	Dental Providers	Dental Hygienist		Group - Multi-Specialty
No	126800000X	Dental Providers	Dental Assistant		Group - Multi-Specialty
No	101YS0200X	Behavioral Health & Social Service Providers	Counselor	School	Group - Multi-Specialty
No	103TB0200X	Behavioral Health & Social Service Providers	Psychologist	Cognitive & Behavioral	Group - Multi-Specialty
No	104100000X	Behavioral Health & Social Service Providers	Social Worker		Group - Multi-Specialty
No	1041S0200X	Behavioral Health & Social Service Providers	Social Worker	School	Group - Multi-Specialty
No	103TA0400X	Behavioral Health & Social Service Providers	Psychologist	Addiction (Substance Use Disorder)	Group - Multi-Specialty
No	101YA0400X	Behavioral Health & Social Service Providers	Counselor	Addiction (Substance Use Disorder)	Group - Multi-Specialty

Provider Identifiers

State	Identifier ID	ID Type	Issuer
ME	104200104	Medicaid
ME	104200115	Medicaid
ME	104200106	Medicaid
ME	104200205	Medicaid
ME	104200101	Medicaid
ME	104200204	Medicaid
ME	104200207	Medicaid
ME	104200208	Medicaid
ME	104200301	Medicaid
ME	104200100	Medicaid
ME	104200105	Medicaid
ME	104200107	Medicaid
ME	104200102	Medicaid
ME	104200200	Medicaid
ME	104200103	Medicaid
ME	104200202	Medicaid
ME	104200203	Medicaid
ME	104200300	Medicaid
ME	104200202	Medicaid
ME	104200205	Medicaid