| Next Step Domestic Violence Project | |
|
733 Bangor Rd Ellsworth ME 04605-3580 | |
| (207) 667-0176 | |
| (207) 667-8033 |
| Full Name | Next Step Domestic Violence Project |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 733 Bangor Rd, Ellsworth, Maine |
| Authorized Official Name and Position | Dorathy Martell (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 2076670176 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Next Step Domestic Violence Project Po Box 1466 Ellsworth ME 04605-1466 Ph: (207) 667-0176 | Next Step Domestic Violence Project 733 Bangor Rd Ellsworth ME 04605-3580 Ph: (207) 667-0176 |
| NPI Number | 1073037099 |
|---|---|
| Provider Enumeration Date | 08/01/2017 |
| Last Update Date | 08/01/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073037099 | NPI | - | NPPES |
| XL-4560 | Other | ME | LCPC-C LICENSE NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | XL-4560 (Maine) | Primary |
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