Provider Demographics
NPI:1285192880
Name:TERRAPIN THERAPEUTIC COLLABORATIVE
Entity Type:Organization
Organization Name:TERRAPIN THERAPEUTIC COLLABORATIVE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KOURTNEY
Authorized Official - Middle Name:
Authorized Official - Last Name:BARTLETT-KIECHLE
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:978-998-5694
Mailing Address - Street 1:PO BOX 21
Mailing Address - Street 2:
Mailing Address - City:EAST KINGSTON
Mailing Address - State:NH
Mailing Address - Zip Code:03827-0021
Mailing Address - Country:US
Mailing Address - Phone:978-810-1959
Mailing Address - Fax:
Practice Address - Street 1:22 WOBURN ST
Practice Address - Street 2:
Practice Address - City:READING
Practice Address - State:MA
Practice Address - Zip Code:01867-3026
Practice Address - Country:US
Practice Address - Phone:978-998-5694
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-04
Last Update Date:2019-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty