Street, Gordon Powell

Street, Gordon Powell is an individual health care provider with primary practice located at 175 West Broadway , Lincoln ME 04457. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Street, Gordon Powell can be contacted via phone (207) 794-6700.

Contact Information

Primary practice address
175 West Broadway Lincoln ME 04457
Fax: (207) 794-0059
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X PS1177 Maine

Profile Details

NPI number 1184699910
LBN Legal business name Street, Gordon Powell
Credentials PHD
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 23rd, 2006
Last updated Mar 30th, 2023 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1184699910 NPPES
Maine MEDICAID 061698
Maine Other 061698

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