Roberta Jacqueline Mullan, LADC

Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Monmouth, ME

NPI 1376659342 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1376659342
Entity type
Individual (NPI type 1)
Primary specialty
Addiction (Substance Use Disorder) Counselor 101YA0400X
License
LC1420 (ME)
Practice address
256 Cressey Rd
Monmouth, ME 04259-6804
Phone
(207) 933-4092
NPI assigned
Aug 22, 2006
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
LC1420MEMDAddiction (Substance Use Disorder) Counselor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X LC1420 ME Yes

Addresses

Primary practice location

256 Cressey Rd
Monmouth, ME 04259-6804

Mailing address

256 Cressey Rd
Monmouth, ME 04259-6804
Phone (207) 933-4092

Other providers in Monmouth, ME

All providers in Monmouth, ME · Addiction (Substance Use Disorder) Counselor in Maine

Sources for this page

Verify at the official NPI Registry.