# EQ MAINE LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1255070041
- **Authorized official:** DR. ERIC RUTBERG DHED, LCPC (CLINICAL DIRECTOR)
- **Authorized official phone:** (207) 491-6014

## Contact information

- **Practice address:** 233 VILLAGE VIEW STREET, WILTON, ME 04294
- **Practice address phone:** (207) 491-6014
- **Practice address fax:** (888) 876-3908
- **Mailing address:** PO BOX 1082, WILTON, ME 04294-1082
- **Mailing address phone:** (207) 491-6014
- **Mailing address fax:** (888) 876-3908

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YM0800X | Mental Health Counselor | — | NULL | Yes |
| 101YM0800X | Mental Health Counselor | — | — | Yes |

## Other

- **Enumeration date:** 06/01/2022
- **Last updated:** 06/01/2022