Organization
TIDESIDE CLINICAL & PSYCHOLOGICAL SERVICES
Active
Organization
TIDESIDE CLINICAL & PSYCHOLOGICAL SERVICES
Active
Other names
Tideside
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KENNETH A. BEATTIE PH.D. (SOLE OWNER)
(207) 669-6011
Entity
Organization
Contact information
Practice address
64 CHURCH ST, TIDESIDE, ELLSWORTH, ME 04605-1658
(207) 669-6011
(207) 669-6011
Mailing address
94 MILL ST, ORONO, ME 04473-4040
(207) 866-2636
(207) 669-6011
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PS1018
ME
Other
Enumeration date
08/31/2006
Last updated
08/22/2020
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