# PHOENIX MENTAL HEALTH SERVICES, LLC

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

## Provider details

- **NPI number:** 1831200575
- **Authorized official:** MS. BARBARA KERRIGAN LCSW (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (207) 941-1113

## Contact information

- **Practice address:** 444 STILLWATER AVE, SUITE 202, BANGOR, ME 04401-3500
- **Practice address phone:** (207) 941-1113
- **Practice address fax:** (207) 941-1134
- **Mailing address:** 444 STILLWATER AVE, SUITE 202, BANGOR, ME 04401-3500
- **Mailing address phone:** (207) 941-1113
- **Mailing address fax:** (207) 941-1134

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251K00000X | Public Health or Welfare Agency | 468197 | ME | Yes |
| 251K00000X | Public Health or Welfare Agency | 492121 | ME | — |

## Other

- **Enumeration date:** 08/31/2006
- **Last updated:** 08/22/2020