=====================================================
General NPI Number Information
=====================================================
NPI Number | 1790526275
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | TUMBLEWEED'S COUNSELING & CASE MANAGEMENT AGENCY, INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/06/2024
-----------------------------------------------------
Last Update Date | 06/06/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 13 RAILROAD SQ STE 3
-----------------------------------------------------
City | WATERVILLE
-----------------------------------------------------
State | ME
-----------------------------------------------------
Zip | 04901-6139
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 207-612-1075
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 13 RAILROAD SQ STE 3
-----------------------------------------------------
City | WATERVILLE
-----------------------------------------------------
State | ME
-----------------------------------------------------
Zip | 04901-6139
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 207-612-1075
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | CHERYL ANNE FRENCH
-----------------------------------------------------
Credential | LCSW
-----------------------------------------------------
Telephone | 207-612-1075
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YM0800X
-----------------------------------------------------
Taxonomy Name | Mental Health Counselor
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------