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WABANAKI PUBLIC HEALTH AND WELLNESS
NPI 1689335184
Psychologist - Addiction (Substance Use Disorder) in Bangor, ME

Active since January 06, 2022CLIA 20D1048544 · Waiver
157 PARK ST, BANGOR, ME 04401(207) 631-1536(207) 631-0524 Get Directions Write a Review

NPPES record last updated: January 6, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Wabanaki Public Health And Wellness NPPES

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

WABANAKI PUBLIC HEALTH AND WELLNESS (NPI 1689335184) is a healthcare organization registered as an addiction (substance use disorder) in Bangor, Maine and active in the NPI registry since January 2022. The organization holds a CLIA Waiver certificate valid through December 4, 2027, maintains a secondary practice location in Millinocket, and lists Sharon Mae Jordan, Director, as its authorized official.

NPPES Registry Identity

NPI1689335184
Entity TypeOrganization
Primary Taxonomy103TA0400X
Legal Business NameWABANAKI PUBLIC HEALTH AND WELLNESS
Location Address157 PARK STBangor, ME 04401-5093
Mailing AddressPo Box 1356Bangor, ME 04402-1356 · (207) 992-0411 · Fax (207) 631-0524
Phone(207) 631-1536
Fax(207) 631-0524
Organization SubpartNo
Authorized OfficialSharon Mae JordanDirector · (207) 992-0411
Enumeration DateJanuary 6, 2022
NPPES CertifiedJanuary 6, 2022
✔ NPI 1689335184 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 5

★ Primary SpecialtyPsychologist · Addiction (Substance Use Disorder)Behavioral Health & Social Service Providers
Taxonomy Code103TA0400X
Definition
A psychologist with a proficiency that involves the application of psychological treatment of addiction stemming from the use of alcohol and other psychoactive substances (e.g., nicotine, marijuana, cocaine, heroin) or behavioral addictions (e.g., gambling) with the aim of cessation or reduction of use and/or the amelioration of emotional, behavioral, interpersonal and other problems arising from the addictive behavior.
Also ListedCase ManagementTaxonomy 251B00000X
Also ListedPublic Health or WelfareTaxonomy 251K00000X
Also ListedCommunity/Behavioral HealthTaxonomy 251S00000X
Also ListedClinic/Center · Mental Health (Including Community Mental Health Center)Taxonomy 261QM0801X
157 PARK ST, Bangor, ME 04401
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Secondary Practice Location 1

Location 157 Penobscot AveMillinocket, ME 04462-1320 · Phone (207) 631-1536 · Fax (207) 631-0524

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 20D1048544

Wabanaki Public Health And Wellness · Bangor, ME
Active · expires Dec 4, 2027
CLIA Number20D1048544
Laboratory TypePublic Health Laboratories
Certificate Effective DateDecember 5, 2025
Certificate Expiration DateDecember 4, 2027
Laboratory DirectorJayson Hunt
Laboratory Phone(207) 356-5396
Laboratory LocationWabanaki Public Health And Wellness304 Hancock Street Suite 3B, 3C, 3D, Bangor, ME 04401
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 8

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

JOAN REINHOLDTSEN
Counselor (Professional)
157 PARK ST
BANGOR, ME 04401
Penobscot County (207) 992-0410
MS. EDITHE ANNE GAGNON LCSW, DCSW
Social Worker (Clinical)
157 PARK ST, SUITE 35
BANGOR, ME 04401
Penobscot County (207) 945-3911
MS. PATRICIA ANN KENNY LCSW
Social Worker (Clinical)
157 PARK ST, SUITE 35
BANGOR, ME 04401
Penobscot County (207) 992-9453
CAROLE S. BAILEY LCPC-C
Counselor
157 PARK ST, SUITE 5
BANGOR, ME 04401
Penobscot County (207) 992-0410
ERIN WIERZBINSKI
Speech-Language Pathologist
157 PARK ST
BANGOR, ME 04401
Penobscot County (860) 908-5149
LISA MARIE OLIVER LCPC-C
Counselor (Mental Health)
157 PARK ST, SUITE 5
BANGOR, ME 04401
Penobscot County (207) 992-0410
ELIZABETH R SMALL LCSW
Social Worker (Clinical)
157 PARK ST, SUITE 35
BANGOR, ME 04401
Penobscot County (207) 992-9454
MRS. MARCIA ANNE DANIE HALE LSCW
Social Worker
157 PARK ST, SUITE 35
BANGOR, ME 04401
Penobscot County (207) 942-5055

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 Wabanaki Public Health And Wellness's NPI number?

The NPI number for Wabanaki Public Health And Wellness is 1689335184. It was assigned to this organization in the NPPES registry on January 6, 2022.

Where is Wabanaki Public Health And Wellness located?

Wabanaki Public Health And Wellness is located at 157 Park St, Bangor, ME 04401. The listed phone number is (207) 631-1536.

What is Wabanaki Public Health And Wellness's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Addiction (Substance Use Disorder), with taxonomy code 103TA0400X.

Does Wabanaki Public Health And Wellness hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 20D1048544) is associated with this NPI, valid through December 4, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Wabanaki Public Health And Wellness was last updated on January 6, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.