| St Croix Regional Family Health Center | |
|
136 Mill St, Princeton, ME 04668-3344 | |
| (207) 796-5503 | |
| (207) 796-5528 |
| Full Name | St Croix Regional Family Health Center |
|---|---|
| Type | Facility |
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 136 Mill St, Princeton, Maine |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831174614 | NPI | - | NPPES |
| 123350000 | Medicaid | ME |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 152W00000X | Optometrist | (* (Not Available)) | Secondary |
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
| Provider Name | Christine A White |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1336124114 PECOS PAC ID: 8527043371 Enrollment ID: I20040624000143 |
| Provider Name | Gregory M Farrell |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1528141348 PECOS PAC ID: 8022059237 Enrollment ID: I20050518000653 |
| Provider Name | Nima Moghaddas |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1376625426 PECOS PAC ID: 8022045756 Enrollment ID: I20050725000333 |
| Provider Name | Tara C L Dwelley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780649137 PECOS PAC ID: 8022043090 Enrollment ID: I20050928000743 |
| Provider Name | Patricia J Todd-lewis |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1689747479 PECOS PAC ID: 9638170855 Enrollment ID: I20070130000517 |
| Provider Name | Sally A Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457336224 PECOS PAC ID: 7214951730 Enrollment ID: I20070627000223 |
| Provider Name | Peter J Knowles |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1992847180 PECOS PAC ID: 4587820402 Enrollment ID: I20120723000104 |
| Provider Name | Janice S Small |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457724148 PECOS PAC ID: 5890096796 Enrollment ID: I20151218000796 |
| Provider Name | Michael Farrell |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1962950733 PECOS PAC ID: 5496033573 Enrollment ID: I20161024002563 |
| Provider Name | Bridgid Neptune |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831619170 PECOS PAC ID: 0648530212 Enrollment ID: I20180131001411 |
| Provider Name | Phylicia J Bonavida |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710456439 PECOS PAC ID: 4183960081 Enrollment ID: I20190115000485 |
| Provider Name | Tanya Zivkovic |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1679083745 PECOS PAC ID: 7719380500 Enrollment ID: I20210731000214 |
| Provider Name | Brittany J Voisine |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760131510 PECOS PAC ID: 0547657819 Enrollment ID: I20220505001024 |
| Provider Name | Michael A Swope |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184326787 PECOS PAC ID: 6800261579 Enrollment ID: I20230411001448 |
| Provider Name | Yazhou Zhang |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1801241518 PECOS PAC ID: 2567737349 Enrollment ID: I20230906003629 |
| Provider Name | Ernesto Cantu |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1164837605 PECOS PAC ID: 5890096606 Enrollment ID: I20231004001891 |
| Provider Name | Judy Splittgerber |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003996646 PECOS PAC ID: 4284930025 Enrollment ID: I20231120001780 |
| Provider Name | Marisol Rivera |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1043417058 PECOS PAC ID: 4789961178 Enrollment ID: I20231209000048 |
| Provider Name | Andrea J Ford |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1891034278 PECOS PAC ID: 9739628108 Enrollment ID: I20240829000779 |
| Provider Name | Nicole Bradbury |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1366119927 PECOS PAC ID: 3678950912 Enrollment ID: I20240904003311 |
| Mailing Address | Practice Location Address |
|---|---|
| St Croix Regional Family Health Center 136 Mill St, Princeton, ME 04668-3344 Ph: (207) 796-5503 | St Croix Regional Family Health Center 136 Mill St, Princeton, ME 04668-3344 Ph: (207) 796-5503 |