| Reassemble Us Counseling And Coaching, Llc | |
|
169 Anthoine St South Portland ME 04106-4452 | |
| (207) 800-1660 | |
| Not Available |
| Full Name | Reassemble Us Counseling And Coaching, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 169 Anthoine St, South Portland, Maine |
| Authorized Official Name and Position | Kristen Smith (OWNER) |
| Authorized Official Contact | 2078001660 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Reassemble Us Counseling And Coaching, Llc 169 Anthoine St South Portland ME 04106-4452 Ph: () - | Reassemble Us Counseling And Coaching, Llc 169 Anthoine St South Portland ME 04106-4452 Ph: (207) 800-1660 |
| NPI Number | 1518720267 |
|---|---|
| Provider Enumeration Date | 02/05/2024 |
| Last Update Date | 03/11/2024 |
| Certification Date | 03/11/2024 |
| Medicare PECOS PAC ID | 2264879584 |
|---|---|
| Medicare Enrollment ID | O20240322000897 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518720267 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 104100000X | Social Worker | (* (Not Available)) | Primary |
| Provider Name | Kristen D Smith |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1699433680 PECOS PAC ID: 3173960499 Enrollment ID: I20240322001028 |
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