Organization
FOOD ADDICTION CHEMICAL DEPENDENCY CONSULTANTS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DRUSILLA M MYERS LADC CCS (PRESIDENT CEO)
(207) 774-4564
Entity
Organization
Contact information
Practice address
650 MAIN ST, SUITE 103, SO PORTLAND, ME 04106
(207) 774-4564
(207) 774-0006
Mailing address
650 MAIN ST, SUITE 103, SO PORTLAND, ME 04106
(207) 774-4564
(207) 774-0006
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
22146
ME
101YM0800X
Mental Health Counselor
454002
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
126240100
—
ME
Enumeration date
07/09/2006
Last updated
08/23/2010
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