Borealis Mental Health Services LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

BOREALIS MENTAL HEALTH SERVICES LLC

Practice address

61 Main St Ste 60
Bangor, ME 04401-6469

Phone

(207) 922-2158

NPI assigned

Feb 13, 2024

Last updated

Feb 13, 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

Tristan Greenlaw, MED. LCPCNPI 1811471766

Title

Owner and Therapist

Phone

(207) 922-7572

Specialties & licenses 1

Addresses

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.

• Tristan Oliver Greenlaw, LCPC

  • Professional Counselor
  • Bangor, ME
  • NPI 1811471766

  Mental Health

  NPD Authorized official

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

{
    "created_epoch": "1707782400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707782400000",
    "number": "1598529125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "61 MAIN ST STE 60",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044016469",
            "telephone_number": "207-922-2158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "61 MAIN ST STE 60",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044016469",
            "telephone_number": "207-922-2158"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOREALIS MENTAL HEALTH SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-13",
        "last_updated": "2024-02-13",
        "certification_date": "2024-02-13",
        "status": "A",
        "authorized_official_last_name": "GREENLAW",
        "authorized_official_first_name": "TRISTAN",
        "authorized_official_title_or_position": "OWNER AND THERAPIST",
        "authorized_official_telephone_number": "207-922-7572",
        "authorized_official_credential": "MED. LCPC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James P Bonzey, CRNA
• Danyle Marie Boobar, PHARM D
• Rachel Audrey Booker, PMHNP-BC
• Ann Boomer, NNP
• Alan Woodford Boone, M.D.
• Joseph Borer, MD
• Erin Borges
• Ottilia Boros, FNP-C
• Nadine N Bos, DO
• Randy A Bosquet Jr., RPH

• Mental Health Counselor in Bangor, ME
• Providers in Bangor, ME by specialty
• Mental Health Counselor in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.