| Roots & Riptides Psychotherapy Pllc | |
|
4 Market Place Dr Ste 201d York ME 03909-1552 | |
| (207) 994-9453 | |
| (207) 221-1711 |
| Full Name | Roots & Riptides Psychotherapy Pllc |
|---|---|
| Speciality | Social Worker |
| Location | 4 Market Place Dr Ste 201d, York, Maine |
| Authorized Official Name and Position | Rebecca J Boyle (OWNER) |
| Authorized Official Contact | 2072481818 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Roots & Riptides Psychotherapy Pllc Po Box 182 York Harbor ME 03911-0182 Ph: (207) 248-1818 | Roots & Riptides Psychotherapy Pllc 4 Market Place Dr Ste 201d York ME 03909-1552 Ph: (207) 994-9453 |
| NPI Number | 1235840612 |
|---|---|
| Provider Enumeration Date | 12/07/2022 |
| Last Update Date | 02/12/2024 |
| Certification Date | 02/12/2024 |
| Medicare PECOS PAC ID | 9436521713 |
|---|---|
| Medicare Enrollment ID | O20230215000182 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235840612 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 104100000X | Social Worker | (* (Not Available)) | Primary |
| Provider Name | Rebecca Jean Boyle |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1558855247 PECOS PAC ID: 0345612628 Enrollment ID: I20230215000209 |
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