NPI 1518681568

Supportive Care of Maine LLC

Organisation Clinical Psychologist Bangor, ME

Practice location

Address: 516 Mount Hope Ave, Bangor, ME 04401-4215
Phone: (718) 298-2753
Mailing address: 27 Randolph Rd, Howell, NJ 07731-8611

Authorised official

Name: Raphael Lichtshcein
Title: President
Phone: (718) 298-4375

Registered specialties (3)

Clinical Psychologist Primary

Behavioral Health & Social Service Providers Taxonomy 103TC0700X

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Clinical Social Worker

Behavioral Health & Social Service Providers Taxonomy 1041C0700X

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Nurse Practitioner

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 363L00000X

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Registry record

NPI: 1518681568
Entity type: Organization
NPI issued: 3 Oct 2022
Record last updated: 3 Oct 2022

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.