| Full Name | |
|---|---|
| Speciality | Social Worker |
| Location | 293 Blue Rd, Monmouth, Maine |
| Authorized Official Name and Position | Andrew Phinney (PRESIDENT) |
| Authorized Official Contact | 2073709585 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
250 Center St Ste 6 Number 1018 Auburn ME 04210-6152 Ph: (207) 370-9585 | 293 Blue Rd Monmouth ME 04259-6900 Ph: (207) 370-9585 |
| NPI Number | 1821691585 |
|---|---|
| Provider Enumeration Date | 11/17/2020 |
| Last Update Date | 01/23/2025 |
| Certification Date | 01/23/2025 |
| Medicare PECOS PAC ID | 5294139036 |
|---|---|
| Medicare Enrollment ID | O20210802001638 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821691585 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Andrew A Phinney |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1427556331 PECOS PAC ID: 6103220942 Enrollment ID: I20210802001807 |