Healthcare Provider Details

I. General information

NPI: 1285457432
Provider Name (Legal Business Name): THERAPEUTIC ALLIANCE SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/06/2024
Last Update Date: 10/22/2025
Certification Date: 10/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22 PARKWAY S
BREWER ME
04412-1688
US

IV. Provider business mailing address

PO BOX 186
BREWER ME
04412-0186
US

V. Phone/Fax

Practice location:
  • Phone: 207-420-8449
  • Fax:
Mailing address:
  • Phone: 207-420-8449
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: DANIELLE BROWN
Title or Position: OWNER/CLINICIAN
Credential: LCPC, CCS, NCC
Phone: 207-420-8449