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
Phone: (207) 794-6700
Fax: (207) 794-0059
Website:
Health care specialties
| Specialty | Code | License # | 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 2 years ago |
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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1184699910 | NPPES |
| Maine | MEDICAID | 061698 | |
| Maine | Other | 061698 |
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