Southern Maine Psychotherapy Llc | |
20 Mussey Rd Scarborough ME 04074-9570 | |
(207) 200-5621 | |
Not Available |
Full Name | Southern Maine Psychotherapy Llc |
---|---|
Speciality | Social Worker - Clinical |
Location | 20 Mussey Rd, Scarborough, Maine |
Authorized Official Name and Position | Michael Johnston (PROVIDER/OWNER) |
Authorized Official Contact | 2072005621 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Southern Maine Psychotherapy Llc 723 Sawyer St South Portland ME 04106-4642 Ph: (207) 200-5621 | Southern Maine Psychotherapy Llc 20 Mussey Rd Scarborough ME 04074-9570 Ph: (207) 200-5621 |
NPI Number | 1164299194 |
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Provider Enumeration Date | 12/11/2023 |
Last Update Date | 01/22/2024 |
Certification Date | 01/22/2024 |
Identifier | Type | State | Issuer |
---|---|---|---|
1164299194 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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