Doctor Name: | NICHOLAS M. ANGERS |
NPI Number: | 1053559849 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LCPC |
License Number: | CC4105 |
Business Practice Address: | 474 Main St Springvale, ME - 040831409 |
Business Phone Number: | 2073241500 |
Business Fax Number: | 2074905263 |
Mailing Address: | 78 Atlantic Pl, SOUTH PORTLAND |
State: | ME |
Postal Code: | 041062316 |
Phone Number: | 2076616654 |
Fax Number: | 2078427773 |
NPI Enumeration Date: | 02/02/2009 |
NPI Last Update Date: | 04/08/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | CC4105 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | ME |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |