| Fraser Clinical Consultation Services | |
|
27 Wilbur Dr Hampden ME 04444-1420 | |
| (207) 735-7136 | |
| Not Available |
| Full Name | Fraser Clinical Consultation Services |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 27 Wilbur Dr, Hampden, Maine |
| Authorized Official Name and Position | Wallace J Fraser (COUNSELOR) |
| Authorized Official Contact | 2077357136 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Fraser Clinical Consultation Services 27 Wilbur Dr Hampden ME 04444-1420 Ph: (207) 735-7136 | Fraser Clinical Consultation Services 27 Wilbur Dr Hampden ME 04444-1420 Ph: (207) 735-7136 |
| NPI Number | 1629530530 |
|---|---|
| Provider Enumeration Date | 04/01/2019 |
| Last Update Date | 01/11/2024 |
| Certification Date | 01/11/2024 |
| Medicare PECOS PAC ID | 5496199879 |
|---|---|
| Medicare Enrollment ID | O20240214001796 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629530530 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Wallace J Fraser |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1578790499 PECOS PAC ID: 9830533116 Enrollment ID: I20240214002333 |
Hampden Psychological Consultation, Pllc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 108 B Main Road South, Hampden Psychological Consultation, Pllc, Hampden, ME 04444 Phone: 207-862-3370 Fax: 207-862-3350 |