Provider Demographics
NPI:1386878791
Name:SEARSPORT COUNSELING ASSOCIATES
Entity type:Organization
Organization Name:SEARSPORT COUNSELING ASSOCIATES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT, SUPERVISOR
Authorized Official - Prefix:
Authorized Official - First Name:ANN
Authorized Official - Middle Name:J
Authorized Official - Last Name:BARCLAY
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC, LMFT, CCS
Authorized Official - Phone:207-338-9145
Mailing Address - Street 1:PO BOX 674
Mailing Address - Street 2:
Mailing Address - City:SEARSPORT
Mailing Address - State:ME
Mailing Address - Zip Code:04974-0674
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9 FIELD ST
Practice Address - Street 2:SUITE 206
Practice Address - City:BELFAST
Practice Address - State:ME
Practice Address - Zip Code:04915-6661
Practice Address - Country:US
Practice Address - Phone:207-338-9145
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-13
Last Update Date:2009-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME453758101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME128400104Medicaid