Individual
QUASAR CHARLI PHOENIX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCPC-C
Contact information
Practice address
84 HIGH ST APT 201, BIDDEFORD, ME 04005-2643
(207) 383-5672
Mailing address
84 HIGH ST APT 201, BIDDEFORD, ME 04005-2643
(207) 468-2973
Taxonomy
Speciality
Code
Description
License number
State
101200000X
Drama Therapist
—
—
101YM0800X
Mental Health Counselor
Primary
XL6198
ME
221700000X
Art Therapist
—
—
225600000X
Dance Therapist
—
—
225A00000X
Music Therapist
—
—
Other
Enumeration date
08/24/2021
Last updated
02/12/2025
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