Provider Demographics
NPI:1093560492
Name:THREE LITTLE BIRDS THERAPY AND WELLNESS, LLC
Entity Type:Organization
Organization Name:THREE LITTLE BIRDS THERAPY AND WELLNESS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KATIE
Authorized Official - Middle Name:THIBOUTOT
Authorized Official - Last Name:DOLINSKY
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:207-572-5504
Mailing Address - Street 1:201 MAIN ST STE 2
Mailing Address - Street 2:
Mailing Address - City:WESTBROOK
Mailing Address - State:ME
Mailing Address - Zip Code:04092-4763
Mailing Address - Country:US
Mailing Address - Phone:207-572-5504
Mailing Address - Fax:
Practice Address - Street 1:201 MAIN ST STE 2
Practice Address - Street 2:
Practice Address - City:WESTBROOK
Practice Address - State:ME
Practice Address - Zip Code:04092-4763
Practice Address - Country:US
Practice Address - Phone:207-572-5504
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-19
Last Update Date:2024-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty