Patrick Andrew D'Amboise, LCPC
Individual provider Active NPI Counselor · New Gloucester, ME
NPI 1649658162 · NPPES record last updated May 17, 2015
Key facts
- NPI
- 1649658162
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Counselor 101Y00000X
- License
- CC959 (ME)
- Practice address
- 169 Town Farm Rd
New Gloucester, ME 04260-4435 - Phone
- (207) 577-2666
- NPI assigned
- May 17, 2015
- Sex
- Male
- 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
| License | State | Type | Specialty |
|---|---|---|---|
| CC959 | ME | MD | Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | CC959 | ME | Yes |
Addresses
Primary practice location
169 Town Farm Rd
New Gloucester, ME 04260-4435
Mailing address
169 Town Farm Rd
New Gloucester, ME 04260-4435
Phone (207) 577-2666
Other providers in New Gloucester, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 17, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.