Healthcare Provider Details

I. General information

NPI: 1962109884
Provider Name (Legal Business Name): WARRIOR OF THE HEART PSYCHOTHERAPY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/10/2023
Last Update Date: 12/13/2025
Certification Date: 12/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7 MOSS RD
WINDHAM ME
04062-3315
US

IV. Provider business mailing address

7 MOSS RD
WINDHAM ME
04062-3315
US

V. Phone/Fax

Practice location:
  • Phone: 510-394-2544
  • Fax:
Mailing address:
  • Phone: 510-394-2544
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: PALEY BURLIN
Title or Position: OWNER
Credential: MA, LMHC, LCPC
Phone: 510-394-2544