Provider Demographics
NPI:1386461671
Name:PORESKY, BOBBI (CADC)
Entity type:Individual
Prefix:
First Name:BOBBI
Middle Name:
Last Name:PORESKY
Suffix:
Gender:F
Credentials:CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:155 SACO AVE STE 2A
Mailing Address - Street 2:
Mailing Address - City:OLD ORCHARD BEACH
Mailing Address - State:ME
Mailing Address - Zip Code:04064-1623
Mailing Address - Country:US
Mailing Address - Phone:207-880-8870
Mailing Address - Fax:
Practice Address - Street 1:155 SACO AVE STE 2A
Practice Address - Street 2:
Practice Address - City:OLD ORCHARD BEACH
Practice Address - State:ME
Practice Address - Zip Code:04064-1623
Practice Address - Country:US
Practice Address - Phone:207-937-8254
Practice Address - Fax:207-937-8529
Is Sole Proprietor?:No
Enumeration Date:2024-09-26
Last Update Date:2024-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECAC5916101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)