Roots & Riptides Psychotherapy PLLC

Primary specialty

Social WorkerTaxonomy code 104100000X

Legal business name

ROOTS & RIPTIDES PSYCHOTHERAPY PLLC

Practice address

4 Market Place Dr Ste 201D
York, ME 03909-1552

Phone

(207) 994-9453

Fax

(207) 221-1711

NPI assigned

Dec 7, 2022

Last updated

Feb 12, 2024By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Rebecca J Boyle, LCSWNPI 1558855247

Title

Owner

Phone

(207) 248-1818

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ME

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Rebecca Jean Boyle

  • Social Worker
  • Saco, ME
  • NPI 1558855247
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1670371200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707696000000",
    "number": "1235840612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 182",
            "city": "YORK HARBOR",
            "state": "ME",
            "postal_code": "039110182",
            "telephone_number": "207-248-1818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 MARKET PLACE DR STE 201D",
            "city": "YORK",
            "state": "ME",
            "postal_code": "039091552",
            "telephone_number": "207-994-9453",
            "fax_number": "207-221-1711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROOTS & RIPTIDES PSYCHOTHERAPY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-12-07",
        "last_updated": "2024-02-12",
        "certification_date": "2024-02-12",
        "status": "A",
        "authorized_official_last_name": "BOYLE",
        "authorized_official_first_name": "REBECCA",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "207-248-1818",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marian Elizabeth Reilly, R.PH.
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• Elizabeth S Robinson, DO
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• Barry M Salter, M.D.
• Santini Family Chiropractic, LLC
• Christopher Paul Santini, D.C.

• Social Worker in York, ME
• Providers in York, ME by specialty
• Social Worker in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.