Organization
UMBRELLA MENTAL HEALTH SERVICES, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARJORIE ELAINE AVERILL LCSW (PRESIDENT/OWNER)
(207) 563-3022
Entity
Organization
Contact information
Practice address
73 BISCAY RD, DAMARISCOTTA, ME 04543-4614
(207) 563-3022
(207) 563-3061
Mailing address
PO BOX 157, NOBLEBORO, ME 04555-0157
(207) 563-3022
(207) 563-3061
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
486719
ME
364SP0807X
Child & Adolescent Psychiatric/Mental Health Clinical Nurse Specialist
486719
ME
364SP0809X
Adult Psychiatric/Mental Health Clinical Nurse Specialist
486719
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
432269200
—
ME
01
—
9187290
AETNA
ME
Enumeration date
08/30/2006
Last updated
03/13/2009
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