# FOOD ADDICTION CHEMICAL DEPENDENCY CONSULTANTS LLC

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

## Provider details

- **NPI number:** 1881627958
- **Authorized official:** MRS. DRUSILLA M MYERS LADC CCS (PRESIDENT CEO)
- **Authorized official phone:** (207) 774-4564

## Contact information

- **Practice address:** 650 MAIN ST, SUITE 103, SO PORTLAND, ME 04106
- **Practice address phone:** (207) 774-4564
- **Practice address fax:** (207) 774-0006
- **Mailing address:** 650 MAIN ST, SUITE 103, SO PORTLAND, ME 04106
- **Mailing address phone:** (207) 774-4564
- **Mailing address fax:** (207) 774-0006

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | 22146 | ME | Yes |
| 101YM0800X | Mental Health Counselor | 454002 | ME | — |

## Other

- **Enumeration date:** 07/09/2006
- **Last updated:** 08/23/2010

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 126240100 | — | ME |