# THRIVEWORKS TELEPSYCHIATRY - MAINE

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

## Provider details

- **NPI number:** 1649909797
- **Authorized official:** NATHAN MILLER (CREDENTIALING)
- **Authorized official phone:** (540) 217-6461

## Contact information

- **Practice address:** 550 FOREST AVE STE 201, PORTLAND, ME 04101-1505
- **Practice address phone:** (855) 284-7483
- **Mailing address:** PO BOX 748465, ATLANTA, GA 30374-8465
- **Mailing address phone:** (855) 284-7483

## Taxonomy

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

## Other

- **Enumeration date:** 06/06/2022
- **Last updated:** 02/11/2025