Bryan J. Double, LCPC
Individual provider Active NPI Mental Health Counselor · Orono, ME
NPI 1659679355 · NPPES record last updated Jul 11, 2024
Key facts
- NPI
- 1659679355
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- Practice address
- 5 Austin Dr
Orono, ME 04473-3603 - Phone
- (207) 484-8147
- NPI assigned
- Mar 3, 2011
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in ME
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240119002651 | ME | Practitioner - Mental Health Counselor | 6507218062 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cornerstone Behavioral Healthcare, LLC | Current |
Accepting new patients |
Locations
157 Park St
Ste 5
Bangor, ME 04401
Phone (207) 992-0410
222 Saint John St
Ste 113
Portland, ME 04102
Phone (207) 772-2440
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | Yes |
Addresses
Primary practice location
5 Austin Dr
Orono, ME 04473-3603
Mailing address
5 Austin Drive
Bangor, ME 04736
Phone (207) 484-8147
Other providers in Orono, ME
- Kathryn J Day
- Dennis Mullins PT
- Dignified Medical Care, LLC
- Julie Dinces
- Walter Doerfler
- Jessica Marie Drew
- Nichole Dunn
- Hannah Leigh Dyer
- Earth Angels Home Care LLC
- Edward Northam
All providers in Orono, ME · Mental Health Counselor in Maine
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 11, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.