| Stonycreek Psychotherapy And Wellness Llc | |
|
52 Cove St Portland ME 04101-2514 | |
| (207) 400-5296 | |
| Not Available |
| Full Name | Stonycreek Psychotherapy And Wellness Llc |
|---|---|
| Speciality | Counselor |
| Location | 52 Cove St, Portland, Maine |
| Authorized Official Name and Position | Laura Watters (OWNER) |
| Authorized Official Contact | 2079565977 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Stonycreek Psychotherapy And Wellness Llc 52 Cove St Portland ME 04101-2514 Ph: (207) 956-5977 | Stonycreek Psychotherapy And Wellness Llc 52 Cove St Portland ME 04101-2514 Ph: (207) 400-5296 |
| NPI Number | 1922612936 |
|---|---|
| Provider Enumeration Date | 09/08/2020 |
| Last Update Date | 09/11/2020 |
| Certification Date | 09/11/2020 |
| Medicare PECOS PAC ID | 4688027170 |
|---|---|
| Medicare Enrollment ID | O20240131004135 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922612936 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
| Provider Name | Kristel Hill |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1114541802 PECOS PAC ID: 4688027006 Enrollment ID: I20240201000481 |
| Provider Name | Thadius Hannington-berube |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1538749692 PECOS PAC ID: 3375996705 Enrollment ID: I20240201000594 |
| Provider Name | Lorraine Fern |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1184230047 PECOS PAC ID: 7810331972 Enrollment ID: I20240216000209 |
| Provider Name | Rachel Brennan |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1275391948 PECOS PAC ID: 2961840210 Enrollment ID: I20240404003418 |
| Provider Name | Amanda Scola |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407474497 PECOS PAC ID: 5193128403 Enrollment ID: I20240412003445 |
| Provider Name | Laura M Watters |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1033534557 PECOS PAC ID: 8123471612 Enrollment ID: I20240708000722 |
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