| Maine Therapy Collective Pllc | |
|
257 Deering Ave Ste 201 Portland ME 04103-4858 | |
| (207) 910-2021 | |
| Not Available |
| Full Name | Maine Therapy Collective Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 257 Deering Ave Ste 201, Portland, Maine |
| Authorized Official Name and Position | Ryan Noel (OWNER) |
| Authorized Official Contact | 2079102021 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Maine Therapy Collective Pllc 31 Doughty Farm Rd Gray ME 04039-9301 Ph: (415) 926-9168 | Maine Therapy Collective Pllc 257 Deering Ave Ste 201 Portland ME 04103-4858 Ph: (207) 910-2021 |
| NPI Number | 1831911361 |
|---|---|
| Provider Enumeration Date | 10/28/2024 |
| Last Update Date | 10/28/2024 |
| Certification Date | 10/27/2024 |
| Medicare PECOS PAC ID | 4385178011 |
|---|---|
| Medicare Enrollment ID | O20241118000125 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831911361 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Ryan Noel |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1801558192 PECOS PAC ID: 8921496373 Enrollment ID: I20241118000164 |
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