| Sunderland Counseling And Coaching Llc | |
|
97 Forest Ave Orono ME 04473-3653 | |
| (207) 355-5777 | |
| (888) 845-9306 |
| Full Name | Sunderland Counseling And Coaching Llc |
|---|---|
| Speciality | Social Worker |
| Location | 97 Forest Ave, Orono, Maine |
| Authorized Official Name and Position | Marsha Fenton (CREDENTIALING SPECIALIST) |
| Authorized Official Contact | 7148416885 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sunderland Counseling And Coaching Llc 97 Forest Ave Orono ME 04473-3653 Ph: (207) 355-5777 | Sunderland Counseling And Coaching Llc 97 Forest Ave Orono ME 04473-3653 Ph: (207) 355-5777 |
| NPI Number | 1417424995 |
|---|---|
| Provider Enumeration Date | 11/01/2018 |
| Last Update Date | 11/01/2018 |
| Medicare PECOS PAC ID | 0042554438 |
|---|---|
| Medicare Enrollment ID | O20181212001723 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417424995 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Secondary |
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Summer R J Sunderland |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1801083621 PECOS PAC ID: 7416026711 Enrollment ID: I20080513000098 |
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