Goodwill Industries Of Northern New England - Medicare Mental Health Clinic in Portland, ME

Goodwill Industries Of Northern New England is a medicare enrolled mental health clinic (Clinic/center - Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (corf)) in Portland, Maine. The current practice location for Goodwill Industries Of Northern New England is 75 Washington Avenue, Suite 300, Portland, Maine. For appointments, you can reach them via phone at (207) 774-6323. The mailing address for Goodwill Industries Of Northern New England is 75 Washington Avenue, Suit 300, Portland, Maine and phone number is (207) 774-6323.

Goodwill Industries Of Northern New England is licensed to practice in * (Not Available) (license number ). The clinic also participates in the medicare program and its NPI number is 1588785463. This medical practice accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at (207) 774-6323.

Contact Information

Goodwill Industries Of Northern New England
75 Washington Avenue
Suite 300
Portland
ME 04101
(207) 774-6323
(207) 761-8460

Mental Health Clinic Profile

Full NameGoodwill Industries Of Northern New England
SpecialityClinic/Center
Location75 Washington Avenue, Portland, Maine
Authorized Official Name and PositionSharlene Adams (SENIOR DIRECTOR, CLINICAL SVC)
Authorized Official Contact2077956110
Accepts Medicare InsuranceYes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Goodwill Industries Of Northern New England
75 Washington Avenue
Suit 300
Portland
ME 04101

Ph: (207) 774-6323
Goodwill Industries Of Northern New England
75 Washington Avenue
Suite 300
Portland
ME 04101

Ph: (207) 774-6323

NPI Details:

NPI Number1588785463
Provider Enumeration Date04/02/2007
Last Update Date07/22/2014

Medicare PECOS Information:

Medicare PECOS PAC ID7911961032
Medicare Enrollment IDO20041117000895

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Medical Identifiers

Medical identifiers for Goodwill Industries Of Northern New England such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1588785463NPI-NPPES
104490002MedicaidME
104490100MedicaidME
104490300MedicaidME
104490303MedicaidME
104490000MedicaidME
104490200MedicaidME
104490001MedicaidME
104490301MedicaidME
104490201MedicaidME
104490302MedicaidME

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
103TP2701XPsychologist - Group Psychotherapy (* (Not Available))Secondary
225100000XPhysical Therapist (* (Not Available))Secondary
225X00000XOccupational Therapist (* (Not Available))Secondary
225XN1300XOccupational Therapist - Neurorehabilitation (* (Not Available))Secondary
231H00000XAudiologist (* (Not Available))Secondary
251S00000XCommunity/behavioral Health (* (Not Available))Secondary
261QR0400XClinic/center - Rehabilitation (* (Not Available))Secondary
261QR0401XClinic/center - Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (corf) (* (Not Available))Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Goodwill Industries Of Northern New England acts as a billing entity for following providers:
Provider NameMeridyth R Astrosky
Provider TypePractitioner - Occupational Therapist In Private Practice
Provider IdentifiersNPI Number: 1376734665
PECOS PAC ID: 4486618345
Enrollment ID: I20041119000206

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Provider NameJill A Welch
Provider TypePractitioner - Occupational Therapist In Private Practice
Provider IdentifiersNPI Number: 1326269432
PECOS PAC ID: 8820198070
Enrollment ID: I20070717000463

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