| Mental Health Associates Of Maine Llc | |
|
251 Woodford St Portland ME 04103-5617 | |
| (207) 773-2828 | |
| (207) 761-8150 |
| Full Name | Mental Health Associates Of Maine Llc |
|---|---|
| Speciality | Psychologist |
| Location | 251 Woodford St, Portland, Maine |
| Authorized Official Name and Position | Carla Kingston (ADMINISTRATOR) |
| Authorized Official Contact | 2077732828 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mental Health Associates Of Maine Llc 251 Woodford St Portland ME 04103-5617 Ph: (207) 773-2828 | Mental Health Associates Of Maine Llc 251 Woodford St Portland ME 04103-5617 Ph: (207) 773-2828 |
| NPI Number | 1508936196 |
|---|---|
| Provider Enumeration Date | 11/09/2006 |
| Last Update Date | 10/25/2012 |
| Medicare PECOS PAC ID | 2961565817 |
|---|---|
| Medicare Enrollment ID | O20090120000552 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508936196 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | (* (Not Available)) | Primary |
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Secondary |
| Provider Name | John M Obrien |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1720083504 PECOS PAC ID: 2769427020 Enrollment ID: I20050627001032 |
| Provider Name | Matthew L Johnson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1427114537 PECOS PAC ID: 9032130463 Enrollment ID: I20051214000035 |
| Provider Name | Charles T Vanamee |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1164413068 PECOS PAC ID: 4284633124 Enrollment ID: I20090105000238 |
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