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DOROTHEA DIX PSYCHIATRIC CENTER OUT PATIENT SERVICES
NPI 1184020091
Community/Behavioral Health in Bangor, ME

Active since November 05, 2014CLIA 20D0089428 · Waiver
656 STATE ST, BANGOR, ME 04401(207) 287-7418(207) 287-1862 Get Directions Write a Review

NPPES record last updated: June 14, 2019. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jun 14, 2019, May 7, 2019 (2 updates tracked since 2019).

About Dorothea Dix Psychiatric Center Out Patient Services NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DOROTHEA DIX PSYCHIATRIC CENTER OUT PATIENT SERVICES (NPI 1184020091) is a healthcare organization registered as a community/behavioral health in Bangor, Maine and active in the NPI registry since November 2014. The organization holds a CLIA Waiver certificate valid through November 6, 2026 and lists Carol Webb Cody, Financial Manager, as its authorized official.

NPPES Registry Identity

NPI1184020091
Entity TypeOrganization
Primary Taxonomy251S00000X
Legal Business NameSTATE OF MAINE
Location Address656 STATE STBangor, ME 04401-5609
Mailing Address109 Capitol Street Shs #11, Reimbursement UnitAugusta, ME 04333-0011 · (207) 287-7418
Phone(207) 287-7418
Fax(207) 287-1862
Organization SubpartNo
Authorized OfficialCarol Webb CodyFinancial Manager · (207) 941-4192
Enumeration DateNovember 5, 2014
Last NPPES UpdateJune 14, 20192 updates tracked since enumeration
✔ NPI 1184020091 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCommunity/Behavioral HealthAgencies
Taxonomy Code251S00000X
License✔ Licensed in ME · 681294
Definition
A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment.
656 STATE ST, Bangor, ME 04401
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Other Names 1

Doing Business AsDorothea Dix Psychiatric Center Out Patient Services

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 20D0089428

Dorothea Dix Psychiatric Center · Bangor, ME
Active · expires Nov 6, 2026
CLIA Number20D0089428
Laboratory TypeHospital
Certificate Effective DateNovember 7, 2024
Certificate Expiration DateNovember 6, 2026
Laboratory DirectorDaniel P. Potenza
Laboratory Phone(207) 941-4000
Laboratory LocationDorothea Dix Psychiatric Center656 State Street, Bangor, ME 04401
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JUDY A BURK MD
Psychiatry & Neurology (Psychiatry)
656 STATE ST, DOROTHEA DIX PSYCHIATRIC CENTER
BANGOR, ME 04401
Penobscot County (207) 941-4263
JEFFREY WHITEHEAD ASTON PH.D
Psychologist
656 STATE ST
BANGOR, ME 04401
Penobscot County (207) 941-4036
MAURICE PARE DO
Family Medicine (Adult Medicine)
656 STATE ST
BANGOR, ME 04401
Penobscot County (207) 941-4036
KRISTIN LITTLEFIELD MOTR/L
Occupational Therapist
656 STATE ST
BANGOR, ME 04401
Penobscot County (207) 561-5581
CAITLIN ANN BREIDT PMHNP
Nurse Practitioner (Psychiatric/Mental Health)
656 STATE ST
BANGOR, ME 04401
Penobscot County (207) 561-5400
MR. PHILIP ALAN WALTON CSW-IP
Social Worker (Clinical)
656 STATE ST
BANGOR, ME 04401
Penobscot County (207) 941-4036
LISA ANNE FIDLER LCSW
Social Worker (Clinical)
656 STATE ST
BANGOR, ME 04401
Penobscot County (207) 941-4036
ELLEN M QUERY NP
Nurse Practitioner
656 STATE ST
BANGOR, ME 04401
Penobscot County (207) 941-4036

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is State Of Maine's NPI number?

The NPI number for State Of Maine is 1184020091. It was assigned to this organization in the NPPES registry on November 5, 2014. The provider is doing business as Dorothea Dix Psychiatric Center Out Patient Services.

Where is State Of Maine located?

State Of Maine is located at 656 State St, Bangor, ME 04401. The listed phone number is (207) 287-7418.

What is State Of Maine's specialty?

The primary specialty registered for this NPI is Community/Behavioral Health with taxonomy code 251S00000X.

Does State Of Maine hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 20D0089428) is associated with this NPI, valid through November 6, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for State Of Maine was last updated on June 14, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.