| Amy Goode Lcsw Llc | |
|
47 Main St Ste 235 Bangor ME 04401-6330 | |
| (207) 241-9697 | |
| Not Available |
| Full Name | Amy Goode Lcsw Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 47 Main St Ste 235, Bangor, Maine |
| Authorized Official Name and Position | Amy E Goode (CLINICAL SOCIAL WORKER/THERAPIST) |
| Authorized Official Contact | 2072720744 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Amy Goode Lcsw Llc Po Box 574 Topsham ME 04086-0574 Ph: (207) 272-0744 | Amy Goode Lcsw Llc 47 Main St Ste 235 Bangor ME 04401-6330 Ph: (207) 241-9697 |
| NPI Number | 1588355713 |
|---|---|
| Provider Enumeration Date | 05/18/2023 |
| Last Update Date | 09/20/2023 |
| Certification Date | 09/20/2023 |
| Medicare PECOS PAC ID | 3375903289 |
|---|---|
| Medicare Enrollment ID | O20230724001502 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588355713 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
| Provider Name | Amy Goode |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1992396857 PECOS PAC ID: 8527475268 Enrollment ID: I20210325001602 |
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