| Spooky Barbie Healing Llc | |
|
613 S Main St Apt 1 Brewer ME 04412-2530 | |
| (207) 356-7904 | |
| (207) 573-1104 |
| Full Name | Spooky Barbie Healing Llc |
|---|---|
| Speciality | Counselor |
| Location | 613 S Main St Apt 1, Brewer, Maine |
| Authorized Official Name and Position | Ashley M Homstead (OWNER, DIRECTOR) |
| Authorized Official Contact | 2073567904 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Spooky Barbie Healing Llc 613 S Main St Apt 1 Brewer ME 04412-2530 Ph: (207) 356-7904 | Spooky Barbie Healing Llc 613 S Main St Apt 1 Brewer ME 04412-2530 Ph: (207) 356-7904 |
| NPI Number | 1427764570 |
|---|---|
| Provider Enumeration Date | 01/23/2023 |
| Last Update Date | 10/15/2024 |
| Certification Date | 10/15/2024 |
| Medicare PECOS PAC ID | 8224561576 |
|---|---|
| Medicare Enrollment ID | O20241025000938 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427764570 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Ashley M. Homstead |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1639635782 PECOS PAC ID: 5799224176 Enrollment ID: I20240829001356 |
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