Tide Meadow Counseling Llc | |
1132 Route 1 Suite 5 York ME 03909-0390 | |
(207) 450-6565 | |
Not Available |
Full Name | Tide Meadow Counseling Llc |
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Speciality | Counselor |
Location | 1132 Route 1 Suite 5, York, Maine |
Authorized Official Name and Position | Elizabeth Ehret Bardwell (PRESIDENT) |
Authorized Official Contact | 2074506565 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Tide Meadow Counseling Llc Po Box 893 York Harbor ME 03911-0893 Ph: (207) 450-6565 | Tide Meadow Counseling Llc 1132 Route 1 Suite 5 York ME 03909-0390 Ph: (207) 450-6565 |
NPI Number | 1134990153 |
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Provider Enumeration Date | 01/09/2024 |
Last Update Date | 01/09/2024 |
Certification Date | 01/08/2024 |
Medicare PECOS PAC ID | 4789029711 |
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Medicare Enrollment ID | O20240229003320 |
Identifier | Type | State | Issuer |
---|---|---|---|
1134990153 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
Provider Name | Elizabeth Bardwell |
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Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1821330721 PECOS PAC ID: 5395182067 Enrollment ID: I20240318003160 |
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