WABANAKI PUBLIC HEALTH AND WELLNESS
NPI 1689335184
Psychologist - Addiction (Substance Use Disorder) in Bangor, ME
NPI Status: Active since January 06, 2022
Contact Information
157 PARK ST
BANGOR, ME
ZIP 04401
Phone: (207) 631-1536
Fax: (207) 631-0524
- Organization
- Psychologist
- Addiction (Substance Use Disorder)
- CLIA Number: 20D1048544
- CLIA Cert. Type: Public Health Laboratories
- CLIA Exp. Date: 12-04-2025
About WABANAKI PUBLIC HEALTH AND WELLNESS
This page provides the complete NPI Profile along with additional information for Wabanaki Public Health And Wellness, a provider established in Bangor, Maine operating as a Psychologist, focusing in addiction (substance use disorder) . The healthcare provider is registered in the NPI registry with number 1689335184 assigned on January 2022. The practitioner's primary taxonomy code is 103TA0400X. The provider is registered as an organization and their NPI record was last updated 4 years ago. The authorized official of this NPI record is Sharon Mae Jordan Lcsw (Director)
- NPI
- 1689335184
- Provider Name
- WABANAKI PUBLIC HEALTH AND WELLNESS
- Entity Type
- Organization
- Location Address
- 157 PARK ST BANGOR, ME 04401
- Location Phone
- (207) 631-1536
- Location Fax
- (207) 631-0524
- Mailing Address
- PO BOX 1356 BANGOR, ME 04402
- Mailing Phone
- (207) 992-0411
- Mailing Fax
- (207) 631-0524
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 01-06-2022
- Last Update Date
- 01-06-2022
- Code Navigator
Location Map
Secondary Locations
- 57 Penobscot Ave
Millinocket, ME 04462
(207) 631-1536
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Psychologist Addiction (Substance Use Disorder)
- Taxonomy Code
- 103TA0400X
- Type
- Behavioral Health & Social Service Providers
- Taxonomy Description
- 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.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 251B00000X | Agencies | Case Management | |
| 2 | 251K00000X | Agencies | Public Health or Welfare | |
| 3 | 251S00000X | Agencies | Community/Behavioral Health | |
| 4 | 261QM0801X | Ambulatory Health Care Facilities | Clinic/Center |
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 20D1048544
- Facility Type
- Public Health Laboratories
- Certificate Effective Date
- December 05, 2023
- Certificate Expiration Date
- December 04, 2025
- Laboratory Director
- SHARON TOMAH JORDAN
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Wabanaki Public Health And Wellness to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 6 | 8 | 9 | 3 | 3 | 5 | 1 | 8 | 4 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 6 | 16 | 9 | 6 | 3 | 10 | 1 | 16 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 6 + 1 + 6 + 9 + 6 + 3 + 1 + 0 + 1 + 1 + 6 + 24 = 66 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 70 - 66 = 4 | 4 | ||||||||
The NPI number 1689335184 is valid because the calculated check digit 4 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 8 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1275627374 | MS. PATRICIA ANN KENNY LCSW Individual | Social Worker (Clinical) | 157 PARK ST SUITE 35 BANGOR, ME 04401 (207) 992-9453 |
| 1265594832 | MS. EDITHE ANNE GAGNON LCSW, DCSW Individual | Social Worker (Clinical) | 157 PARK ST SUITE 35 BANGOR, ME 04401 (207) 945-3911 |
| 1891945176 | ELIZABETH R SMALL LCSW Individual | Social Worker (Clinical) | 157 PARK ST SUITE 35 BANGOR, ME 04401 (207) 992-9454 |
| 1306285895 | CAROLE S. BAILEY LCPC-C Individual | Counselor | 157 PARK ST SUITE 5 BANGOR, ME 04401 (207) 992-0410 |
| 1316321581 | ERIN WIERZBINSKI Individual | Speech-Language Pathologist | 157 PARK ST BANGOR, ME 04401 (860) 908-5149 |
| 1871036178 | LISA MARIE OLIVER LCPC-C Individual | Counselor (Mental Health) | 157 PARK ST SUITE 5 BANGOR, ME 04401 (207) 992-0410 |
| 1932288156 | MRS. MARCIA ANNE DANIE HALE LSCW Individual | Social Worker | 157 PARK ST SUITE 35 BANGOR, ME 04401 (207) 942-5055 |
| 1003212945 | JOAN REINHOLDTSEN Individual | Counselor (Professional) | 157 PARK ST BANGOR, ME 04401 (207) 992-0410 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1689335184, enumerated in the NPI registry as an "organization" on January 06, 2022
The provider is located at 157 Park St Bangor, Me 04401 and the phone number is (207) 631-1536
This medical organization specializes in Psychologist with taxonomy code 103TA0400X with a focus in Addiction (Substance Use Disorder)
The provider's CLIA number is 20D1048544 for a "public health laboratories" facility with a CLIA Certificate of Waiver. This CLIA certificate is issued to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria..
This NPI record was last updated on January 06, 2022. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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