| Healing Roots Behavioral Health Center, Llc | |
|
325c Kennedy Memorial Dr Ste 2 Waterville ME 04901-4517 | |
| (207) 649-2762 | |
| Not Available |
| Full Name | Healing Roots Behavioral Health Center, Llc |
|---|---|
| Speciality | Counselor |
| Location | 325c Kennedy Memorial Dr Ste 2, Waterville, Maine |
| Authorized Official Name and Position | Venessa Folsom (OWNER, CLINICIAN) |
| Authorized Official Contact | 2076492762 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Healing Roots Behavioral Health Center, Llc 295 Abbott Rd Winslow ME 04901-0002 Ph: (107) 649-2762 | Healing Roots Behavioral Health Center, Llc 325c Kennedy Memorial Dr Ste 2 Waterville ME 04901-4517 Ph: (207) 649-2762 |
| NPI Number | 1982160156 |
|---|---|
| Provider Enumeration Date | 02/13/2019 |
| Last Update Date | 02/13/2019 |
| Medicare PECOS PAC ID | 6709315799 |
|---|---|
| Medicare Enrollment ID | O20250121000567 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982160156 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Venessa Rae Folsom |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1164723532 PECOS PAC ID: 7517496508 Enrollment ID: I20250121000772 |
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