Individual
CASEY E HARRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CADC, MHRT-C
Contact information
Practice address
629 MAIN ST, BANGOR, ME 04401-6848
(207) 990-2870
(207) 990-2298
Mailing address
629 MAIN ST, BANGOR, ME 04401-6848
(207) 990-2870
(207) 990-2298
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CAC4607
ME
171M00000X
Case Manager/Care Coordinator
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CAC4607
STATE OF MAINE - CERTIFIED ALCOHOL AND DRUG COUNSELOR LICENSE
ME
Enumeration date
09/20/2010
Last updated
09/20/2010
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