| Bangor Counseling Center | |
|
202 Exchange St Bangor ME 04401-6508 | |
| (207) 941-6434 | |
| (207) 941-9366 |
| Full Name | Bangor Counseling Center |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 202 Exchange St, Bangor, Maine |
| Authorized Official Name and Position | Lorna M Lyons (ADMINISTRATIVE SUPERVISOR) |
| Authorized Official Contact | 2079416434 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bangor Counseling Center 202 Exchange St Bangor ME 04401-6508 Ph: (207) 941-6434 | Bangor Counseling Center 202 Exchange St Bangor ME 04401-6508 Ph: (207) 941-6434 |
| NPI Number | 1851432041 |
|---|---|
| Provider Enumeration Date | 02/09/2007 |
| Last Update Date | 10/29/2009 |
| Medicare PECOS PAC ID | 2365486263 |
|---|---|
| Medicare Enrollment ID | O20050613000185 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851432041 | NPI | - | NPPES |
| 121150001 | Medicaid | ME | |
| 121150100 | Medicaid | ME |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 392936 (Maine) | Primary |
| Provider Name | Jennifer W Weaver |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1730377839 PECOS PAC ID: 7911913694 Enrollment ID: I20060306000125 |
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