Provider Demographics
NPI:1609572718
Name:COUNSELING ONFIRE LLC
Entity Type:Organization
Organization Name:COUNSELING ONFIRE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:
Authorized Official - First Name:KELLIE
Authorized Official - Middle Name:M
Authorized Official - Last Name:WESTBERRY
Authorized Official - Suffix:
Authorized Official - Credentials:LADC CCS
Authorized Official - Phone:207-550-7439
Mailing Address - Street 1:19 COMMONS AVE STE 7
Mailing Address - Street 2:
Mailing Address - City:WINDHAM
Mailing Address - State:ME
Mailing Address - Zip Code:04062-5836
Mailing Address - Country:US
Mailing Address - Phone:207-550-7439
Mailing Address - Fax:207-893-8611
Practice Address - Street 1:19 COMMONS AVE STE 7
Practice Address - Street 2:
Practice Address - City:WINDHAM
Practice Address - State:ME
Practice Address - Zip Code:04062-5836
Practice Address - Country:US
Practice Address - Phone:207-550-7439
Practice Address - Fax:207-893-8611
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-01
Last Update Date:2023-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty