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General NPI Number Information
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NPI Number | 1770464042
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Entity Type | Organization
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Legal Business Name | THISTLE WELLNESS LLC
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Dates
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Enumeration Date | 09/11/2025
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 25 MIDDLE ST
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City | PORTLAND
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State | ME
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Zip | 04101-4869
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Country | US
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Telephone | 207-200-1402
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Fax |
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Provider Business Mailing Address
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Address Line | 16 WESTWOOD AVE
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City | SCARBOROUGH
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State | ME
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Zip | 04074-9524
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Country | US
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Telephone | 207-200-1402
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MARIA THOMAS
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Credential | LCPCC
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Telephone | 207-200-1402
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State | NULL
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