MID-COAST FAMILY WELLNESS CENTER, LLC (NPI# 1255846531) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255846531 |
| Entity Type | Organization |
| Organization Name | MID-COAST FAMILY WELLNESS CENTER, LLC |
| Other Organization Name | MIDCOAST FAMILY WELLNESS CENTER |
| Practice Address |
219 Route One Ste 101 Edgecomb ME 04556-3000 |
| Practice Telephone | 2073505788 |
| Mailing Telephone | 2073505788 |
| Enumeration Date | 2017-12-07 |
| Last Update Date | 2017-12-07 |
| Authorized Official Name | PIA MARANCIK (LICENSED PSYCHOLOGIST) |
| Authorized Official Telephone | 2073509875 |
| Authorized Official Credential | PH.D |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
PS1389 | ME | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ME | 1386978849 | 05 |
| Other Name | Type Code |
|---|---|
| Midcoast Family Wellness Center | Doing Business As Name - Organization |
| Street Address |
219 ROUTE ONE STE 101 |
| City | EDGECOMB |
| State | ME |
| Zip Code | 04556-3000 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497924153 | Barbara Dudley Thompson | Counselor | 166 Spring Hill Farm Rd, Edgecomb, ME 04556 | 2008-02-27 |
| 1417166505 | Laurie J Robinson | Physician Assistant | 24b Route 1, Edgecomb, ME 04556 | 2007-05-22 |
| 1487186680 | Jeni Nagy | Health Educator | 219 Route One, Suite 101, Edgecomb, ME 04556-3000 | 2017-03-28 |
| 1639733850 | Alissa Elizabeth Berryman | Registered Nurse | 321 Shore Rd, Edgecomb, ME 04556-3204 | 2019-04-23 |
| 1700087459 | Eldercare Network of Lincoln County | Assisted Living Facility | 31 Cross Point Rd, Edgecomb, ME 04556-3247 | 2007-05-30 |
| 1366549008 | Kathryn Anne Rohr | Orthopaedic Surgery | 122 Merry Island Rd, Edgecomb, ME 04556-3418 | 2006-09-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497924153 | Barbara Dudley Thompson | Counselor | 166 Spring Hill Farm Rd, Edgecomb, ME 04556 | 2008-02-27 |
| 1174703201 | Diana Lyn James | Counselor | 428 Rte 1, Edgecomb, ME 04455 | 2007-11-06 |
| 1700087459 | Eldercare Network of Lincoln County | Assisted Living Facility | 31 Cross Point Rd, Edgecomb, ME 04556-3247 | 2007-05-30 |
| 1417166505 | Laurie J Robinson | Physician Assistant | 24b Route 1, Edgecomb, ME 04556 | 2007-05-22 |
| 1366549008 | Kathryn Anne Rohr | Orthopaedic Surgery | 122 Merry Island Rd, Edgecomb, ME 04556-3418 | 2006-09-17 |
| 1639733850 | Alissa Elizabeth Berryman | Registered Nurse | 321 Shore Rd, Edgecomb, ME 04556-3204 | 2019-04-23 |
| Taxonomy Code | 261QM0801X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Mental Health (Including Community Mental Health Center) |
| Definition to come... |
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|---|---|---|---|---|
| 1679172118 | Acorn & Oak, LLC | Clinic/Center | 6 Elm Street, #1, Kennebunk, ME 04043-7449 | 2020-10-24 |
| 1326682774 | New Hope Residential Care | Clinic/Center | 43 Rollins Way, South Portland, ME 04106-1942 | 2019-10-29 |
| 1821654112 | Hand of Mercy Health Care, LLC | Clinic/Center | 1087 Forest Ave, Portland, ME 04103-3321 | 2019-05-13 |
| 1700358314 | Nikki Wetherell Counseling | Clinic/Center | 19 South St Ste 6, Portland, ME 04101-3963 | 2018-12-20 |
| 1952870792 | Psychwellness, LLC | Clinic/Center | 169 Park Row Ste 6, Brunswick, ME 04011-2039 | 2018-11-23 |
| 1073037099 | Next Step Domestic Violence Project | Clinic/Center | 733 Bangor Rd, Ellsworth, ME 04605-3580 | 2017-08-01 |
| 1306170295 | Department of Veterans Affairs | Clinic/Center | 99 River Rd, Lincoln, ME 04457-4012 | 2009-09-24 |
| 1881831329 | Wings for Children and Families Inc. | Clinic/Center | 900 Hammond St, Suite 915, Bangor, ME 04401-4378 | 2009-01-20 |
| 1891733309 | Maine Behavioral Healthcare | Clinic/Center | 2 Springbrook Dr, Biddeford, ME 04005-9443 | 2006-06-04 |
| 1538122445 | Sweetser | Clinic/Center | 50 Moody Street, Saco, ME 04072 | 2006-04-11 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.