| Thriveworks Telepsychiatry - Maine | |
|
550 Forest Ave Ste 201 Portland ME 04101-1505 | |
| (855) 284-7483 | |
| Not Available |
| Full Name | Thriveworks Telepsychiatry - Maine |
|---|---|
| Speciality | Counselor |
| Location | 550 Forest Ave Ste 201, Portland, Maine |
| Authorized Official Name and Position | Nathan Miller (CREDENTIALING) |
| Authorized Official Contact | 5402176461 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Thriveworks Telepsychiatry - Maine 1000 Jefferson St Ste 2c Lynchburg VA 24504-1724 Ph: (540) 217-6461 | Thriveworks Telepsychiatry - Maine 550 Forest Ave Ste 201 Portland ME 04101-1505 Ph: (855) 284-7483 |
| NPI Number | 1649909797 |
|---|---|
| Provider Enumeration Date | 06/06/2022 |
| Last Update Date | 06/06/2022 |
| Certification Date | 06/06/2022 |
| Medicare PECOS PAC ID | 3678947769 |
|---|---|
| Medicare Enrollment ID | O20230313000094 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649909797 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Catherine Ann Yu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669604112 PECOS PAC ID: 6406993914 Enrollment ID: I20140627001780 |
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