Organization
LENFEST CLINICAL SERVICES PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRAVIS JEROME LENFEST LCSW, LADC, CCS (THERAPIST)
(207) 631-8968
Entity
Organization
Contact information
Practice address
139 STATE ST STE 2, BANGOR, ME 04401-5317
(207) 631-8968
Mailing address
139 STATE ST STE 2, BANGOR, ME 04401-5317
(207) 631-8968
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
—
324500000X
Substance Abuse Rehabilitation Facility
—
—
Other
Enumeration date
02/27/2022
Last updated
03/31/2022
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