NPIMap

Organization Active NPI

Food Addiction Chemical Dependency Consultants LLC

  • Addiction (Substance Use Disorder) Counselor
  • So Portland, ME
National Provider Identifier
1881627958
Registry record updated Aug 23, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
22146 Issued in ME
Legal business name
FOOD ADDICTION CHEMICAL DEPENDENCY CONSULTANTS LLC
Practice address
650 Main St
Suite 103
So Portland, ME 04106
Phone
(207) 774-4564
Fax
(207) 774-0006
NPI assigned
Jul 9, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2010

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

Authorized official

Name
Mrs. Drusilla M Myers, LADC CCS
Title
President Ceo
Phone
(207) 774-4564

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YA0400X 22146 ME Primary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X 454002 ME

Addresses

Primary practice location

650 Main St
Suite 103
So Portland, ME 04106

Mailing address

650 Main St
Suite 103
So Portland, ME 04106
Phone (207) 774-4564

Other identifiers 1

IdentifierTypeStateIssuer
126240100MedicaidME

National Provider Directory

National Provider Directory

Locations

650 Main St
Ste 103
South Portland, ME 04106
Phone (207) 239-6406

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1152403200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1282521600000",
    "number": "1881627958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "650 MAIN ST",
            "address_2": "SUITE 103",
            "city": "SO PORTLAND",
            "state": "ME",
            "postal_code": "04106",
            "telephone_number": "207-774-4564",
            "fax_number": "207-774-0006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 MAIN ST",
            "address_2": "SUITE 103",
            "city": "SO PORTLAND",
            "state": "ME",
            "postal_code": "04106",
            "telephone_number": "207-774-4564",
            "fax_number": "207-774-0006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOOD ADDICTION CHEMICAL DEPENDENCY CONSULTANTS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-09",
        "last_updated": "2010-08-23",
        "status": "A",
        "authorized_official_last_name": "MYERS",
        "authorized_official_first_name": "DRUSILLA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT CEO",
        "authorized_official_telephone_number": "207-774-4564",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LADC CCS"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "ME",
            "license": "22146",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "ME",
            "license": "454002",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "126240100",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in So Portland, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2010; 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.