Alicia Marie Antiuk, LADC, MHRT/C
Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Medway, ME
NPI 1972371060 · NPPES record last updated Dec 18, 2023
Key facts
- NPI
- 1972371060
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Addiction (Substance Use Disorder) Counselor 101YA0400X
- License
- LC8637 (ME)
- Practice address
- 2323 Medway Rd
Medway, ME 04460-3106 - Phone
- (207) 249-0840
- NPI assigned
- Dec 18, 2023
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|
| LC8637 | ME | MD | Addiction (Substance Use Disorder) Counselor |
| 35230 | ME | MD | Case Manager/Care Coordinator |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | 35230 | ME | |
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | LC8637 | ME | Yes |
Addresses
Primary practice location
2323 Medway Rd
Medway, ME 04460-3106
Mailing address
3 Main St
East Millinocket, ME 04430-1220
Phone (207) 249-0840
Other providers in Medway, ME
All providers in Medway, ME · Addiction (Substance Use Disorder) 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 Dec 18, 2023. 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.