# BELFAST COUNSELING LLC

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

## Provider details

- **NPI number:** 1982442455
- **Authorized official:** ERICKA TIDMORE TRAVERS LCPC-C, LADC, CCS (MANAGING EMPLOYEE)
- **Authorized official phone:** (207) 561-7269

## Contact information

- **Practice address:** 26 SPRING ST, BELFAST, ME 04915-6817
- **Practice address phone:** (207) 561-7269
- **Mailing address:** 26 SPRING ST, BELFAST, ME 04915-6817
- **Mailing address phone:** (207) 561-7269

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | — | NULL | — |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | — | — | — |
| 101YM0800X | Mental Health Counselor | — | NULL | Yes |
| 101YM0800X | Mental Health Counselor | — | — | Yes |
| 101YP2500X | Professional Counselor | — | NULL | — |
| 101YP2500X | Professional Counselor | — | — | — |

## Other

- **Enumeration date:** 07/18/2024
- **Last updated:** 07/18/2024