| R Melvin Counseling Llc | |
|
251 Woodford St Portland ME 04103-5617 | |
| (207) 773-2828 | |
| (207) 761-8150 |
| Full Name | R Melvin Counseling Llc |
|---|---|
| Speciality | Social Worker |
| Location | 251 Woodford St, Portland, Maine |
| Authorized Official Name and Position | Randall R Melvin (MEMBER) |
| Authorized Official Contact | 2077732828 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| R Melvin Counseling Llc 251 Woodford St Portland ME 04103-5617 Ph: (207) 773-2828 | R Melvin Counseling Llc 251 Woodford St Portland ME 04103-5617 Ph: (207) 773-2828 |
| NPI Number | 1265972749 |
|---|---|
| Provider Enumeration Date | 03/02/2017 |
| Last Update Date | 03/02/2017 |
| Medicare PECOS PAC ID | 9638440258 |
|---|---|
| Medicare Enrollment ID | O20170801000103 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265972749 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | LC4787 (Maine) | Primary |
| Provider Name | Randall R Melvin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1669495974 PECOS PAC ID: 3678500386 Enrollment ID: I20050725000930 |
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