| Wild North Counseling Llc | |
|
41 Depot St Ste 204 Bridgton ME 04009-2298 | |
| (207) 803-8735 | |
| Not Available |
| Full Name | Wild North Counseling Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 41 Depot St Ste 204, Bridgton, Maine |
| Authorized Official Name and Position | Tighe Blackadar (OWNER) |
| Authorized Official Contact | 2078038735 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Wild North Counseling Llc 41 Depot St Ste 204 Bridgton ME 04009-2298 Ph: (207) 803-8735 | Wild North Counseling Llc 41 Depot St Ste 204 Bridgton ME 04009-2298 Ph: (207) 803-8735 |
| NPI Number | 1174359012 |
|---|---|
| Provider Enumeration Date | 09/09/2024 |
| Last Update Date | 09/09/2024 |
| Certification Date | 09/09/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174359012 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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