MARISSA DODGE LADC, CCS
NPI 1396502720
Counselor - Addiction (Substance Use Disorder) in Poland, ME
Active since March 04, 2024
About Marissa Dodge Ladc, Ccs NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MARISSA DODGE LADC, CCS (NPI 1396502720) is an individual addiction (substance use disorder) provider in Poland, Maine, licensed in Maine (CCS8524) and active in the NPI registry since March 2024.
NPPES Registry Identity
NPI1396502720
Entity TypeIndividualFemale
Primary Taxonomy101YA0400X
Provider Legal NameMARISSA DODGECredential: LADC, CCS
Location Address9 SUNDERLAND RDPoland, ME 04274-7500
Mailing Address9 Sunderland RdPoland, ME 04274-7500 · (207) 522-9608
Phone(207) 522-9608
Sole ProprietorYes
Enumeration DateMarch 4, 2024
NPPES CertifiedFebruary 21, 2024
✔ NPI 1396502720 is a valid, active identifier and passes the ISO check-digit test.
Specialties & Licenses
★ Primary SpecialtyCounselor · Addiction (Substance Use Disorder)Behavioral Health & Social Service Providers
Taxonomy Code101YA0400X
Licenses✔ Licensed in ME · CCS8524✔ Licensed in ME · LC7702
9 SUNDERLAND RD, Poland, ME 04274
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1396502720, enumerated as an "individual" on March 04, 2024.
The provider is located at 9 SUNDERLAND RD POLAND, ME 04274 and the phone number is (207) 522-9608.
Counselor with taxonomy code 101YA0400X and a focus in Addiction (Substance Use Disorder).
