| Wellspace Maine | |
|
30 Danforth St Ste 311 Portland ME 04101-4574 | |
| (207) 619-3356 | |
| (207) 300-6085 |
| Full Name | Wellspace Maine |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 30 Danforth St Ste 311, Portland, Maine |
| Authorized Official Name and Position | Lindy Graham (OWNER/PSYCHOTHERAPIST) |
| Authorized Official Contact | 2076193356 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Wellspace Maine Po Box 8484 Portland ME 04104-8484 Ph: (207) 619-3356 | Wellspace Maine 30 Danforth St Ste 311 Portland ME 04101-4574 Ph: (207) 619-3356 |
| NPI Number | 1932607801 |
|---|---|
| Provider Enumeration Date | 01/25/2018 |
| Last Update Date | 07/18/2024 |
| Certification Date | 07/18/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932607801 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | LC10604 (Maine) | Primary |
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