| Behavioral Health Center | |
|
12 Stillwater Ave Ste 7 Bangor ME 04401-3984 | |
| (207) 941-0879 | |
| (207) 941-0880 |
| Full Name | Behavioral Health Center |
|---|---|
| Speciality | Social Worker |
| Location | 12 Stillwater Ave Ste 7, Bangor, Maine |
| Authorized Official Name and Position | Christopher Andrew Pooler (PRACTICE MANAGER) |
| Authorized Official Contact | 2079410879 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Behavioral Health Center 12 Stillwater Ave Ste 7 Bangor ME 04401-3984 Ph: (207) 941-0879 | Behavioral Health Center 12 Stillwater Ave Ste 7 Bangor ME 04401-3984 Ph: (207) 941-0879 |
| NPI Number | 1841795127 |
|---|---|
| Provider Enumeration Date | 03/28/2018 |
| Last Update Date | 08/13/2024 |
| Certification Date | 08/13/2024 |
| Medicare PECOS PAC ID | 6204191471 |
|---|---|
| Medicare Enrollment ID | O20180518000259 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841795127 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Loida E Ruane |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1205010717 PECOS PAC ID: 1355570144 Enrollment ID: I20140127000104 |
| Provider Name | Colleen E Hurley |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1588085039 PECOS PAC ID: 0941439244 Enrollment ID: I20140207001287 |
| Provider Name | Darin E Knapp |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1730493826 PECOS PAC ID: 2567753122 Enrollment ID: I20160629000872 |
| Provider Name | Garrett A Randolph |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1942712773 PECOS PAC ID: 0840557369 Enrollment ID: I20171207002664 |
| Provider Name | Dara K Mcintire |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1083127617 PECOS PAC ID: 4284051087 Enrollment ID: I20200825001557 |
| Provider Name | Emily A Yenco |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1144866633 PECOS PAC ID: 9739597550 Enrollment ID: I20210415002779 |
| Provider Name | Lucus E Temple |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1467081646 PECOS PAC ID: 4284003112 Enrollment ID: I20221215000418 |
| Provider Name | Brooklin Jones-banahan |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1003427535 PECOS PAC ID: 7113398991 Enrollment ID: I20230116000523 |
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