Healthcare Provider Details

I. General information

NPI: 1508785098
Provider Name (Legal Business Name): BLUE ASTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/10/2026
Last Update Date: 07/10/2026
Certification Date: 06/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 BURLEIGH ST
WATERVILLE ME
04901
US

IV. Provider business mailing address

325 MAIN ST # 353
WATERVILLE ME
04901-4922
US

V. Phone/Fax

Practice location:
  • Phone: 207-200-4967
  • Fax:
Mailing address:
  • Phone: 207-200-4967
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DARBY BEAULIEU
Title or Position: MANAGING CLINICIAN
Credential: LCSW, CCS
Phone: 207-200-4967