Healthcare Provider Details

I. General information

NPI: 1659194850
Provider Name (Legal Business Name): PERPETUALLY BECOMING THERAPY & WELLNESS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/05/2024
Last Update Date: 11/05/2024
Certification Date: 10/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1265 ROOSEVELT TRL
RAYMOND ME
04071-6608
US

IV. Provider business mailing address

139 GORE RD
RAYMOND ME
04071-5500
US

V. Phone/Fax

Practice location:
  • Phone: 207-239-1691
  • Fax:
Mailing address:
  • Phone: 207-239-1691
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: STEPHANIE ROWLAND
Title or Position: THERAPIST/OWNER
Credential: LCSW
Phone: 207-239-1691