Provider Demographics
NPI:1730201898
Name:FACING CHANGE, PA
Entity type:Organization
Organization Name:FACING CHANGE, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:LUDWIG
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW,LADC,CCS
Authorized Official - Phone:207-784-0922
Mailing Address - Street 1:4 PARK ST
Mailing Address - Street 2:SUITE 1
Mailing Address - City:LEWISTON
Mailing Address - State:ME
Mailing Address - Zip Code:04240-7128
Mailing Address - Country:US
Mailing Address - Phone:207-784-0922
Mailing Address - Fax:207-784-6143
Practice Address - Street 1:4 PARK ST
Practice Address - Street 2:SUITE 1
Practice Address - City:LEWISTON
Practice Address - State:ME
Practice Address - Zip Code:04240-7128
Practice Address - Country:US
Practice Address - Phone:207-784-0922
Practice Address - Fax:207-784-6143
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-06
Last Update Date:2010-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME220581251K00000X
ME221421251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME09819655OtherDIRIGO
ME129500000Medicaid
MEME 0269OtherHARVARD PILGRIM
ME098156OtherANTHEM
ME103922OtherNANCY'S # FOR MERIT B.C.
ME279870OtherVALUE OPTIONS
MEA391919OtherGREAT WESTERN INSURANCE
ME42678OtherAGENCY # FOR MERIT B.C.
ME5202793OtherAETNA
MEA511899180001OtherCIGNA
ME017366OtherDIRIGO
ME2015010OtherNANCY'S # FOR B.H.
ME2118169OtherBEHAVIORAL HEALTH FOR F.C
ME237557OtherMAGELLAN'S # FOR NANCY
ME804560OtherTUFTS
MEME 0269OtherHARVARD PILGRIM