Organization
THE UMBRELLA AGENCY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARJORIE E AVERILL LCSW (PRESIDENT)
(207) 563-3022
Entity
Organization
Contact information
Practice address
73 BISCAY RD, DAMARISCOTTA, ME 04543
(207) 563-3022
(207) 563-6146
Mailing address
PO BOX 38, NOBLEBORO, ME 04555-0038
(207) 563-3022
(207) 563-6146
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
682863
ME
101YM0800X
Mental Health Counselor
Primary
682861
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1013311521
—
ME
Enumeration date
10/13/2014
Last updated
02/09/2015
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