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MS. CYNTHIA MARIE CHASE LCPC, LADC, CCS

Addiction Substance Use Disorder

Brunswick, Maine

Provider NPI: 1194779942

Provider Information:
MS. CYNTHIA MARIE CHASE LCPC, LADC, CCS
Gender: F
Sole Proprietor


Practice Location:
39 BARIBEAU DR  BRUNSWICK, ME 04011 US
Tel: 207-522-2073  Fax: 207-729-1803

Business Mailing Address:
19 WESTERN AVE  TOPSHAM, ME 04086 US
Tel: 207-729-1803  Fax: 207-777-8669

Entity Type: Individual

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
N101YA0400XBehavioral Health & Social Service Providers
Counselor
Addiction (Substance Use Disorder)
MELC1491
Y101YM0800XBehavioral Health & Social Service Providers
Counselor
MECC1723

Other Provider Identifiers:

IssuerNumberStateType
ANTHEM048265ME01
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin







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