Basic Information
| Provider Information | |||||||||
| NPI: | 1699904102 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MCFARLANE | ||||||||
| FirstName: | PATRICK | ||||||||
| MiddleName: | S | ||||||||
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| Credential: | PMHNP, LCSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 43 WHITING HILL RD | ||||||||
| Address2: | SUITE 300 | ||||||||
| City: | BREWER | ||||||||
| State: | ME | ||||||||
| PostalCode: | 044121005 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2079735035 | ||||||||
| FaxNumber: | 2079735042 | ||||||||
| Practice Location | |||||||||
| Address1: | 895 UNION ST | ||||||||
| Address2: | SUITE 12 | ||||||||
| City: | BANGOR | ||||||||
| State: | ME | ||||||||
| PostalCode: | 044013053 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2079737979 | ||||||||
| FaxNumber: | 2079479579 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/06/2009 | ||||||||
| LastUpdateDate: | 04/16/2015 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | LC12020 | ME | N | Behavioral Health & Social Service Providers | Social Worker | Clinical | 363LP0808X | CNP131095 | ME | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Psych/Mental Health |
ID Information
| ID | Type | State | Issuer | Description | 434251199 | 05 | ME | MEDICAID |