Pine State Telehealth Therapy LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

PINE STATE TELEHEALTH THERAPY LLC

Practice address

110 Wilderness LN
Bowdoinham, ME 04008-6059

Phone

(207) 209-3123

NPI assigned

Jun 26, 2024

Last updated

Jun 26, 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

Mary Stanton, LCSWNPI 1427684372

Title

Owner

Phone

(207) 209-3123

Specialties & licenses 1

Addresses

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.

• Mary Stanton, LCSW

  • Clinical Social Worker
  • Bowdoinham, ME
  • NPI 1427684372

  Mental Health

  NPD Authorized official

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

{
    "created_epoch": "1719360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719360000000",
    "number": "1801631569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 231",
            "city": "RICHMOND",
            "state": "ME",
            "postal_code": "043570231",
            "telephone_number": "207-209-3123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 WILDERNESS LN",
            "city": "BOWDOINHAM",
            "state": "ME",
            "postal_code": "040086059",
            "telephone_number": "207-209-3123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PINE STATE TELEHEALTH THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-26",
        "last_updated": "2024-06-26",
        "certification_date": "2024-06-26",
        "status": "A",
        "authorized_official_last_name": "STANTON",
        "authorized_official_first_name": "MARY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "207-209-3123",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lighthouse Community Care LLC
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• Lost in the Woods Counseling LLC
• Stephanie Miller
• Shirley Parker, LADC, CCS
• Mary Stanton, LCSW
• Melinda Kae Stevenson, RN
• Anna Taglieri

• Mental Health Counselor in Bowdoinham, ME
• Providers in Bowdoinham, 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 Jun 26, 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.