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Individual

ERICKA TIDMORE TRAVERS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCPC-C, LADC, CCS

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
LC7487
ME
101YM0800X
Mental Health Counselor
Primary
XL6874
ME

Other

Enumeration date
11/08/2019
Last updated
10/12/2023
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