Stonybrook Mental Health

Primary specialty

Early Intervention Provider AgencyTaxonomy code 252Y00000X

Legal business name

STONYBROOK MENTAL HEALTH

Practice address

875 Hammond St
Bangor, ME 04401-4303

Phone

(207) 664-8529

NPI assigned

Jun 8, 2018

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Richard G Corey

Title

Owner

Phone

(207) 664-8529

Specialties & licenses 3

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1528416000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1528416000000",
    "number": "1811480452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 72",
            "city": "HOLDEN",
            "state": "ME",
            "postal_code": "044290072",
            "telephone_number": "207-664-8529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "875 HAMMOND ST",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044014303",
            "telephone_number": "207-664-8529"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STONYBROOK MENTAL HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-08",
        "last_updated": "2018-06-08",
        "status": "A",
        "authorized_official_last_name": "COREY",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "207-664-8529",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Early Intervention Provider Agency in Bangor, ME
• Providers in Bangor, ME by specialty
• Early Intervention Provider Agency in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.