| Healing Tide Therapy Llc | |
|
29 Eliot St South Portland ME 04106-5919 | |
| (207) 615-2022 | |
| Not Available |
| Full Name | Healing Tide Therapy Llc |
|---|---|
| Speciality | Counselor - Addiction (substance Use Disorder) |
| Location | 29 Eliot St, South Portland, Maine |
| Authorized Official Name and Position | Susan Emily Worcester (CLINICIAN / OWNER) |
| Authorized Official Contact | 2076152022 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Healing Tide Therapy Llc 29 Eliot St South Portland ME 04106-5919 Ph: (207) 615-2022 | Healing Tide Therapy Llc 29 Eliot St South Portland ME 04106-5919 Ph: (207) 615-2022 |
| NPI Number | 1245846971 |
|---|---|
| Provider Enumeration Date | 09/18/2020 |
| Last Update Date | 09/18/2020 |
| Certification Date | 09/18/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245846971 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Primary |
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
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