# MIND BODY THERAPY MAINE LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1316894686
- **Authorized official:** MS. ANDREA MICHAUD LCSW (DIRECTOR)
- **Authorized official phone:** (207) 749-7473

## Contact information

- **Practice address:** 38 PLEASANT ST, PORTLAND, ME 04101-3964
- **Practice address phone:** (207) 749-7473
- **Mailing address:** 38 PLEASANT ST, PORTLAND, ME 04101-3964
- **Mailing address phone:** (207) 749-7473

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YM0800X | Mental Health Counselor | — | NULL | Yes |
| 101YM0800X | Mental Health Counselor | — | — | Yes |

## Other

- **Enumeration date:** 03/14/2026
- **Last updated:** 03/14/2026