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Organization
BELFAST COUNSELING LLC
Active
Organization
BELFAST COUNSELING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ERICKA TIDMORE TRAVERS LCPC-C, LADC, CCS (MANAGING EMPLOYEE)
(207) 561-7269
Entity
Organization
Contact information
Practice address
26 SPRING ST, BELFAST, ME 04915-6817
(207) 561-7269
Mailing address
26 SPRING ST, BELFAST, ME 04915-6817
(207) 561-7269
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
NULL
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
Primary
—
NULL
101YM0800X
Mental Health Counselor
Primary
—
—
101YP2500X
Professional Counselor
—
NULL
101YP2500X
Professional Counselor
—
—
Other
Enumeration date
07/18/2024
Last updated
07/18/2024
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