Breathing Space LLC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

CC3042 Issued in ME

Legal business name

BREATHING SPACE LLC

Practice address

132 Main St
Suite 205
Bridgton, ME 04009-1127

Phone

(207) 212-9512

NPI assigned

Sep 27, 2011

Last updated

Sep 27, 2011By 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

Anne W Polak, LCPC

Title

Owner

Phone

(207) 212-9512

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1317081600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1317081600000",
    "number": "1841573789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 445",
            "city": "BRIDGTON",
            "state": "ME",
            "postal_code": "040090445",
            "telephone_number": "207-212-9512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "132 MAIN ST",
            "address_2": "SUITE 205",
            "city": "BRIDGTON",
            "state": "ME",
            "postal_code": "040091127",
            "telephone_number": "207-212-9512"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BREATHING SPACE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-27",
        "last_updated": "2011-09-27",
        "status": "A",
        "authorized_official_last_name": "POLAK",
        "authorized_official_first_name": "ANNE",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "207-212-9512",
        "authorized_official_credential": "LCPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "ME",
            "license": "CC3042",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cindy Ann Black, LCSW
• Tighe Blackadar, MSW, LCSW
• Hans Boedeker, MD
• Karen S Bogdan, OT
• Maria L Brake, LMT
• Audreigh Anna Brede, PT, DPT
• Bridgton Chiropractic Center, Inc.
• Bridgton Dental Associates
• Bridgton Dental Hygiene Care, PA
• Bridgton Eye Care, LLC (Christine Newell, O.D.)

• Professional Counselor in Bridgton, ME
• Providers in Bridgton, ME by specialty
• Professional Counselor in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2011; 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.