| Christina Fay Lcsw Ladc Ccs - Llc | |
|
68 Bishop St Ste 3 Portland ME 04103-2681 | |
| (207) 281-2681 | |
| Not Available |
| Full Name | Christina Fay Lcsw Ladc Ccs - Llc |
|---|---|
| Speciality | Social Worker |
| Location | 68 Bishop St Ste 3, Portland, Maine |
| Authorized Official Name and Position | Christina Fay (PROVIDER/OWNER/SOLE MEMBER) |
| Authorized Official Contact | 2072812681 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Christina Fay Lcsw Ladc Ccs - Llc 140 Sandbar Rd Windham ME 04062-5540 Ph: (207) 281-2681 | Christina Fay Lcsw Ladc Ccs - Llc 68 Bishop St Ste 3 Portland ME 04103-2681 Ph: (207) 281-2681 |
| NPI Number | 1457125031 |
|---|---|
| Provider Enumeration Date | 11/14/2023 |
| Last Update Date | 11/20/2023 |
| Certification Date | 11/20/2023 |
| Medicare PECOS PAC ID | 2365880622 |
|---|---|
| Medicare Enrollment ID | O20240404003691 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457125031 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Christina Fay |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1861704488 PECOS PAC ID: 8921296872 Enrollment ID: I20101220000932 |
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