| Thepleasantoak, Inc | |
|
49 Oak St Augusta ME 04330-5118 | |
| (207) 441-6624 | |
| (207) 622-6290 |
| Full Name | Thepleasantoak, Inc |
|---|---|
| Speciality | Social Worker |
| Location | 49 Oak St, Augusta, Maine |
| Authorized Official Name and Position | Susan A Brochu (LICENSED CLINICAL SOCIAL WORKER) |
| Authorized Official Contact | 2074416624 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Thepleasantoak, Inc 49 Oak St Augusta ME 04330-5118 Ph: (207) 441-6624 | Thepleasantoak, Inc 49 Oak St Augusta ME 04330-5118 Ph: (207) 441-6624 |
| NPI Number | 1275923369 |
|---|---|
| Provider Enumeration Date | 01/28/2015 |
| Last Update Date | 01/28/2015 |
| Medicare PECOS PAC ID | 1456679521 |
|---|---|
| Medicare Enrollment ID | O20150422000076 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275923369 | NPI | - | NPPES |
| ME1038 | Other | ME | ME1038 PCAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | LC7597 (Maine) | Primary |
| Provider Name | Susan A Brochu |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1144311135 PECOS PAC ID: 5395700942 Enrollment ID: I20041123000826 |
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