| Organization Name: | BLUE RIDGE COUNSELING CENTER, P.A. |
| NPI Number: | 1861805806 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | SHARON R NEIL (PRESIDENT) |
| Mailing Address: | 32 Main St Livermore Falls |
| State: | ME US |
| Postal Code: | 042541244 |
| Phone Number: | 2076459770 |
| Fax Number: | 2078979000 |
| NPI Enumeration Date: | 06/07/2014 |
| NPI Last Update Date: | 02/17/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QM0801X |
| License Number: | 683580 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | ME |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Mental Health (Including Community Mental Health Center) |
| Taxonomy Definition: | |