| Evergreen Psychotherapy | |
| 844 Stevens Ave Portland ME 04103-2676 | |
| (508) 243-3580 | |
| Not Available | 
| Full Name | Evergreen Psychotherapy | 
|---|---|
| Speciality | Social Worker - Clinical | 
| Location | 844 Stevens Ave, Portland, Maine | 
| Authorized Official Name and Position | Jaime Mastrorio (OWNER / LCSW) | 
| Authorized Official Contact | 5082433580 | 
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. | 
| Mailing Address | Practice Location Address | 
|---|---|
| Evergreen Psychotherapy 844 Stevens Ave Portland ME 04103-2676 Ph: () - | Evergreen Psychotherapy 844 Stevens Ave Portland ME 04103-2676 Ph: (508) 243-3580 | 
| NPI Number | 1427879840 | 
|---|---|
| Provider Enumeration Date | 10/18/2024 | 
| Last Update Date | 11/15/2024 | 
| Certification Date | 11/15/2024 | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1427879840 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary | 
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