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WABANAKI PUBLIC HEALTH AND WELLNESS NPI 1689335184


NPI Information

NPI: 1689335184
Provider Name: WABANAKI PUBLIC HEALTH AND WELLNESS
Classification: Psychologist - 103TA0400X
Entity Type: Organization

Specialization: Addiction (Substance Use Disorder)

CLIA Number: 20D1048544

Address:
157 PARK ST
BANGOR, ME
ZIP 04401
Phone: (207) 631-1536
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WABANAKI PUBLIC HEALTH AND WELLNESS is an addiction (substance use disorder) psychologist in Bangor, ME. The provider is a psychologist with a proficiency that involves the application of psychological treatment of addiction stemming from the use of alcohol and other psychoactive substances (e.g., nicotine, marijuana, cocaine, heroin) or behavioral addictions (e.g., gambling) with the aim of cessation or reduction of use and/or the amelioration of emotional, behavioral, interpersonal and other problems arising from the addictive behavior. WABANAKI PUBLIC HEALTH AND WELLNESS NPI is 1689335184. The provider is registered as an organization entity type.

The provider's business location address is:

157 PARK ST
BANGOR, ME
ZIP 04401-093
Phone: (207) 631-1536
Fax: (207) 631-0524

The provider's authorized official is Sharon Mae Jordan .
The authorized official title is Director and has the following contact phone number (207) 992-0411.

The CLIA number assigned to this NPI record is 20D1048544 - other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/6/2022 and was last updated on 1/6/2022.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1251B00000XCase ManagementNo
2251K00000XPublic Health or WelfareNo
3251S00000XCommunity/Behavioral HealthNo
4261QM0801XClinic/CenterMental Health (Including Community Mental Health Center)No
5103TA0400XPsychologistAddiction (Substance Use Disorder)Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.