# GOODWILL INDUSTRIES OF NORTHERN NEW ENGLAND

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Goodwill of Maine
- **Organization subpart:** No

## Provider details

- **NPI number:** 1588785463
- **Authorized official:** SHARLENE ADAMS CBIST, LSX (SENIOR DIRECTOR, CLINICAL SVC)
- **Authorized official phone:** (207) 795-6110

## Contact information

- **Practice address:** 75 WASHINGTON AVENUE, SUITE 300, PORTLAND, ME 04101
- **Practice address phone:** (207) 774-6323
- **Practice address fax:** (207) 761-8460
- **Mailing address:** 75 WASHINGTON AVENUE, SUIT 300, PORTLAND, ME 04101
- **Mailing address phone:** (207) 774-6323
- **Mailing address fax:** (207) 761-8460

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 103TP2701X | Group Psychotherapy Psychologist | — | NULL | — |
| 103TP2701X | Group Psychotherapy Psychologist | — | — | — |
| 225100000X | Physical Therapist | — | NULL | — |
| 225100000X | Physical Therapist | — | — | — |
| 225X00000X | Occupational Therapist | — | NULL | — |
| 225X00000X | Occupational Therapist | — | — | — |
| 225XN1300X | Neurorehabilitation Occupational Therapist | — | NULL | — |
| 225XN1300X | Neurorehabilitation Occupational Therapist | — | — | — |
| 231H00000X | Audiologist | — | NULL | — |
| 231H00000X | Audiologist | — | — | — |
| 251S00000X | Community/Behavioral Health Agency | — | NULL | — |
| 261QR0400X | Rehabilitation Clinic/Center | — | NULL | — |
| 261QR0401X | Comprehensive Outpatient Rehabilitation Facility (CORF) | — | NULL | Yes |

## Other

- **Enumeration date:** 04/02/2007
- **Last updated:** 07/22/2014

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 104490000 | — | ME |
| 05 | — | 104490001 | — | ME |
| 05 | — | 104490002 | — | ME |
| 05 | — | 104490100 | — | ME |
| 05 | — | 104490200 | — | ME |
| 05 | — | 104490201 | — | ME |
| 05 | — | 104490300 | — | ME |
| 05 | — | 104490301 | — | ME |
| 05 | — | 104490302 | — | ME |
| 05 | — | 104490303 | — | ME |