| Clinical Consultation & Counseling | |
|
26 River St 2nd Floor Dover Foxcroft ME 04426-1321 | |
| (207) 564-0026 | |
| (877) 822-7919 |
| Full Name | Clinical Consultation & Counseling |
|---|---|
| Speciality | Clinic/Center |
| Location | 26 River St, Dover Foxcroft, Maine |
| Authorized Official Name and Position | David Arthur Goolsby (PRESIDENT) |
| Authorized Official Contact | 2075640026 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Clinical Consultation & Counseling Po Box 370 Dover Foxcroft ME 04426-0370 Ph: (207) 564-0026 | Clinical Consultation & Counseling 26 River St 2nd Floor Dover Foxcroft ME 04426-1321 Ph: (207) 564-0026 |
| NPI Number | 1831416783 |
|---|---|
| Provider Enumeration Date | 04/30/2010 |
| Last Update Date | 04/30/2010 |
| Medicare PECOS PAC ID | 0244474757 |
|---|---|
| Medicare Enrollment ID | O20130924000564 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831416783 | NPI | - | NPPES |
| 431819099 | Medicaid | ME |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | David A Goolsby |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1588664163 PECOS PAC ID: 5698728707 Enrollment ID: I20050301000785 |
| Provider Name | Mary C Goolsby |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1902024870 PECOS PAC ID: 2062570096 Enrollment ID: I20081021000282 |
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