Therapeutic Space With Lara

Primary specialty

Social WorkerTaxonomy code 104100000X

Legal business name

THERAPEUTIC SPACE WITH LARA

Practice address

602 Brighton Ave
Portland, ME 04102-2324

Phone

(207) 939-5080

NPI assigned

Aug 6, 2024

Organization subpart

No

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

Authorized official

Name

Lara NordensonNPI 1093185506

Title

Therapist

Phone

(207) 939-5080

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.

• Lara Nordenson

  • Clinical Social Worker
  • Portland, ME
  • NPI 1093185506
  NPD Authorized official

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

{
    "created_epoch": "1722902400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722902400000",
    "number": "1891525622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38 DOUGLAS MTN RD",
            "city": "SEBAGO",
            "state": "ME",
            "postal_code": "040293122",
            "telephone_number": "207-939-5080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "602 BRIGHTON AVE",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041022324",
            "telephone_number": "207-939-5080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THERAPEUTIC SPACE WITH LARA",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-06",
        "last_updated": "2024-08-06",
        "certification_date": "2024-08-06",
        "status": "A",
        "authorized_official_last_name": "NORDENSON",
        "authorized_official_first_name": "LARA",
        "authorized_official_title_or_position": "THERAPIST",
        "authorized_official_telephone_number": "207-939-5080"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• The Weight Loss & Diabetes Center, LLC
• Thea Skydel Wellness, LLC
• Kaycee Theberge, LMSW-CC
• Matthew A Thees, OD
• Tamer George I Theodory, DDS
• Cam L Theriault, LSW-C
• Denise M Theriault, D.M.D.
• Donald Leon Theriault, DMD
• Clifford Thibodeau, LADC, CCS
• John Thibodeau, LCSW

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 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.