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General NPI Number Information
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NPI Number | 1255207411
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Entity Type | Organization
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Legal Business Name | THE MESETA COLLECTIVE
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Dates
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Enumeration Date | 10/15/2025
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Last Update Date | 12/16/2025
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Provider Practice Location Address
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Address Line | 20 CENTER ST
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City | YARMOUTH
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State | ME
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Zip | 04096-7929
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Country | US
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Telephone | 858-449-7208
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Fax |
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Provider Business Mailing Address
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Address Line | 32 CENTER ST
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City | YARMOUTH
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State | ME
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Zip | 04096-7929
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Country | US
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Telephone | 858-847-0234
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Fax |
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Authorized Official
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Title or Position | OWNER, LPCP-C, NCC
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Name | AMANDA ELIZABETH MITCHELL
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Credential |
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Telephone | 858-449-7208
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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