MEDICARE: HEARTBEAT CIFC, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor

General Provider Information

NPI Number	:	1457182313
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEARTBEAT CIFC, LLC

Provider Business Mailing Address
First Line	:	25 TANGLEWOOD DR
Second Line	:
City	:	GORHAM
State	:	ME
Zip	:	04038-2573
Country	:	US
Telephone Number	:	516-900-4038
Fax Number	:

Provider Business Practice Location Address
First Line	:	169 PARK ROW
Second Line	:
City	:	BRUNSWICK
State	:	ME
Zip	:	04011-2039
Country	:	US
Telephone Number	:	516-900-4038
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	ADELE BARUCH
Credential	:	LCPC
Telephone Number	:	516-900-4038

Provider Enumeration Date	:	08/12/2024
Last Update Date	:	09/05/2024

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