Provider Demographics
NPI:1366513897
Name:ANXIETY SOLUTIONS OF NORTHERN NEW ENGLAND, PLLC
Entity type:Organization
Organization Name:ANXIETY SOLUTIONS OF NORTHERN NEW ENGLAND, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER AND BUSINESS MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:GORDON
Authorized Official - Middle Name:POWELL
Authorized Official - Last Name:STREET
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:207-655-2737
Mailing Address - Street 1:PO BOX 70
Mailing Address - Street 2:
Mailing Address - City:RAYMOND
Mailing Address - State:ME
Mailing Address - Zip Code:04071-0070
Mailing Address - Country:US
Mailing Address - Phone:207-655-2737
Mailing Address - Fax:207-655-1065
Practice Address - Street 1:186 TWIN SPRING LANE
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:ME
Practice Address - Zip Code:04457
Practice Address - Country:US
Practice Address - Phone:207-655-2737
Practice Address - Fax:207-655-1065
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-13
Last Update Date:2025-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103TC0700X
MEPS1176103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty