| Waters Edge Therapy, Inc | |
|
127 Worthing Rd Manchester ME 04351-3234 | |
| (207) 530-0880 | |
| Not Available |
| Full Name | Waters Edge Therapy, Inc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 127 Worthing Rd, Manchester, Maine |
| Authorized Official Name and Position | Dianne M Howard Morand (CLINICIAN) |
| Authorized Official Contact | 2075300880 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Waters Edge Therapy, Inc 127 Worthing Rd Manchester ME 04351-3234 Ph: (207) 530-0880 | Waters Edge Therapy, Inc 127 Worthing Rd Manchester ME 04351-3234 Ph: (207) 530-0880 |
| NPI Number | 1053761270 |
|---|---|
| Provider Enumeration Date | 06/18/2016 |
| Last Update Date | 06/18/2016 |
| Medicare PECOS PAC ID | 9133526510 |
|---|---|
| Medicare Enrollment ID | O20210928001417 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053761270 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (Maine) | Primary |
| Provider Name | Dianne M Howard-morand |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1356619670 PECOS PAC ID: 5698998987 Enrollment ID: I20140513001347 |
| Provider Name | Rebekah J Smith |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1063041697 PECOS PAC ID: 3870990260 Enrollment ID: I20210928001805 |
| Provider Name | Laurie Farley |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1588944722 PECOS PAC ID: 7810347267 Enrollment ID: I20240110000240 |
| Provider Name | Amy Tardy |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1780233445 PECOS PAC ID: 6002264207 Enrollment ID: I20240110001547 |
Crossroads Counseling Center Pllc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 726 Western Ave., Manchester, ME 04351 Phone: 207-512-5131 Fax: 888-293-3442 |