Brett Adam Robertshaw
Individual provider Active NPI Clinical Social Worker · Gray, ME
NPI 1962074880 · NPPES record last updated Jul 12, 2021
Key facts
- NPI
- 1962074880
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- MC19755 (ME)
- Practice address
- 26 Main Street
Gray, ME 04039 - Phone
- (207) 657-7700
- NPI assigned
- Jul 12, 2021
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 2
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 |
|---|---|---|---|
| MC19755 | ME | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Christopher Aaron Counseling Center LLC | Clinical | Current |
Accepting new patients |
| Christopher Aaron Counseling Center | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker |
1041C0700X | MC19755 | ME | Yes |
Addresses
Primary practice location
26 Main Street
Gray, ME 04039
Mailing address
346 Broadway St. Unit 12
South Portland, ME 04106
Phone (207) 332-2959
Other providers in Gray, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 12, 2021. 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.