| Shaker Pond Counseling Llc | |
|
200 Waterboro Rd Alfred ME 04002-3247 | |
| (207) 324-8222 | |
| Not Available |
| Full Name | Shaker Pond Counseling Llc |
|---|---|
| Speciality | Social Worker |
| Location | 200 Waterboro Rd, Alfred, Maine |
| Authorized Official Name and Position | Lana Clough (OWNER) |
| Authorized Official Contact | 2073248222 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Shaker Pond Counseling Llc Po Box 53 Alfred ME 04002-0053 Ph: (207) 324-8222 | Shaker Pond Counseling Llc 200 Waterboro Rd Alfred ME 04002-3247 Ph: (207) 324-8222 |
| NPI Number | 1134628811 |
|---|---|
| Provider Enumeration Date | 02/07/2018 |
| Last Update Date | 02/07/2018 |
| Medicare PECOS PAC ID | 6305266057 |
|---|---|
| Medicare Enrollment ID | O20201019000686 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134628811 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | LC3505 (Maine) | Primary |
| Provider Name | Lana S Clough |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1003827254 PECOS PAC ID: 1759354822 Enrollment ID: I20040817000558 |
York County Shelter Programs, Inc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 147 Shaker Hill Road, Alfred, ME 04002 Phone: 207-324-1137 | |
York County Shelter Programs, Inc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 147 Shaker Hill Road, Alfred, ME 04002 Phone: 207-324-1137 Fax: 207-324-5290 | |
York County Shelter Programs, Inc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 147 Shaker Hill Rd, Alfred, ME 04002 Phone: 207-324-1137 Fax: 207-324-5290 | |
York County Shelter Programs, Inc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 147 Shaker Hill Rd, Alfred, ME 04002 Phone: 207-324-1137 Fax: 207-324-5290 | |
York County Shelter Programs, Inc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 147 Shaker Hill Rd, Alfred, ME 04002 Phone: 207-324-1137 Fax: 207-324-5290 |