Healthcare Provider Details

I. General information

NPI: 1477351328
Provider Name (Legal Business Name): LOST IN THE WOODS COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/06/2025
Last Update Date: 03/06/2025
Certification Date: 03/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

45 FISHER RD
BOWDOINHAM ME
04008-4200
US

IV. Provider business mailing address

45 FISHER RD
BOWDOINHAM ME
04008-4200
US

V. Phone/Fax

Practice location:
  • Phone: 207-450-9362
  • Fax:
Mailing address:
  • Phone: 207-450-9362
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: MR. GRAHAM BOTTO
Title or Position: OWNER/CLINICIAN
Credential: LCSW
Phone: 207-450-9362