Individual
TIMOTHY MICHAEL MCBRADY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPN, LADC, CCS
Contact information
Practice address
2300 CONGRESS ST, PORTLAND, ME 04102-1908
(207) 221-2292
(207) 221-2297
Mailing address
936 ROOSEVELT TRL, STE 14, WINDHAM, ME 04062-5652
(207) 893-0000
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LC1323
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
251760099
—
ME
Enumeration date
05/10/2007
Last updated
12/14/2010
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