| Dirigo Counseling Clinic, Llc | |
|
557 Hammond St Bangor ME 04401-4511 | |
| (207) 973-0505 | |
| (207) 942-2175 |
| Full Name | Dirigo Counseling Clinic, Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 557 Hammond St, Bangor, Maine |
| Authorized Official Name and Position | Alan Algee (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 2079730505 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dirigo Counseling Clinic, Llc 557 Hammond St Bangor Bangor ME 04401-4511 Ph: (207) 973-0505 | Dirigo Counseling Clinic, Llc 557 Hammond St Bangor ME 04401-4511 Ph: (207) 973-0505 |
| NPI Number | 1295734085 |
|---|---|
| Provider Enumeration Date | 07/14/2005 |
| Last Update Date | 10/23/2016 |
| Medicare PECOS PAC ID | 3375767023 |
|---|---|
| Medicare Enrollment ID | O20140619000334 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295734085 | NPI | - | NPPES |
| 432471100 | Medicaid | ME |
| Provider Name | Cynthia E Sturm |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1952658890 PECOS PAC ID: 6507155520 Enrollment ID: I20160516000488 |
| Provider Name | Kimberly L Herz |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1841513777 PECOS PAC ID: 4789977034 Enrollment ID: I20160725000004 |
| Provider Name | Shannon E. Pettit |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1649474156 PECOS PAC ID: 6800151622 Enrollment ID: I20180529001841 |
| Provider Name | Katherine Louise Monahan |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1396016051 PECOS PAC ID: 7315399102 Enrollment ID: I20240117002467 |
| Provider Name | Bruce Bosinger |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1841807823 PECOS PAC ID: 7113379421 Enrollment ID: I20240122003950 |
| Provider Name | Alan Algee |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1942209739 PECOS PAC ID: 4284858937 Enrollment ID: I20240125003854 |
| Provider Name | Robin Sandau |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1730530809 PECOS PAC ID: 4688014137 Enrollment ID: I20240430004496 |
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