| Kingsbury Counseling, Llc | |
|
251 Woodford St Portland ME 04103-5617 | |
| (207) 773-2828 | |
| (207) 761-8150 |
| Full Name | Kingsbury Counseling, Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 251 Woodford St, Portland, Maine |
| Authorized Official Name and Position | Carla Kingston (OFFICE COORDINATOR) |
| Authorized Official Contact | 2077732828 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kingsbury Counseling, Llc 251 Woodford St Portland ME 04103-5617 Ph: (207) 773-2828 | Kingsbury Counseling, Llc 251 Woodford St Portland ME 04103-5617 Ph: (207) 773-2828 |
| NPI Number | 1558954149 |
|---|---|
| Provider Enumeration Date | 02/16/2021 |
| Last Update Date | 02/16/2021 |
| Certification Date | 02/16/2021 |
| Medicare PECOS PAC ID | 8123436177 |
|---|---|
| Medicare Enrollment ID | O20210413000620 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558954149 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Joshua Ryan Kingsbury |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1376888511 PECOS PAC ID: 7618121666 Enrollment ID: I20140324000101 |
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