Provider Demographics
NPI:1134184898
Name:CLOUGH-BELL, CATHERINE (LADC,CCS)
Entity type:Individual
Prefix:
First Name:CATHERINE
Middle Name:
Last Name:CLOUGH-BELL
Suffix:
Gender:F
Credentials:LADC,CCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28 WINTER ST
Mailing Address - Street 2:
Mailing Address - City:NORWAY
Mailing Address - State:ME
Mailing Address - Zip Code:04268-5620
Mailing Address - Country:US
Mailing Address - Phone:207-743-1677
Mailing Address - Fax:207-743-1614
Practice Address - Street 1:28 WINTER ST
Practice Address - Street 2:
Practice Address - City:NORWAY
Practice Address - State:ME
Practice Address - Zip Code:04268-5620
Practice Address - Country:US
Practice Address - Phone:207-743-1677
Practice Address - Fax:207-743-1614
Is Sole Proprietor?:No
Enumeration Date:2006-04-18
Last Update Date:2008-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELC2575101YA0400X
MECCS3082101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME031599OtherANTHEM