Individual
ELLEN HANEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCPC
Contact information
Practice address
17 BISHOP ST, PORTLAND, ME 04103-2659
(207) 871-1235
(207) 879-6161
Mailing address
57 HILLIS ST, PORTLAND, ME 04103-2418
(207) 871-1200
(207) 871-1232
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
CC1537
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
298120099
—
ME
01
—
CAC2975
ALCOHOL AND ABUSE COUNS.
ME
01
—
RB9
ANTHEM
ME
Enumeration date
11/13/2006
Last updated
08/05/2009
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