Provider Demographics
NPI:1700124732
Name:CENTRAL MAINE PSYCHOTHERAPY, PA
Entity Type:Organization
Organization Name:CENTRAL MAINE PSYCHOTHERAPY, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:C
Authorized Official - Last Name:HOWANIEC
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:207-240-8995
Mailing Address - Street 1:460 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LEWISTON
Mailing Address - State:ME
Mailing Address - Zip Code:04240-6755
Mailing Address - Country:US
Mailing Address - Phone:207-240-8995
Mailing Address - Fax:207-784-2232
Practice Address - Street 1:460 MAIN ST
Practice Address - Street 2:
Practice Address - City:LEWISTON
Practice Address - State:ME
Practice Address - Zip Code:04240-6755
Practice Address - Country:US
Practice Address - Phone:207-240-8995
Practice Address - Fax:207-784-2232
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-25
Last Update Date:2013-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECNP81133261QM0850X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health