Provider Demographics
NPI:1184344301
Name:ADAPTIVE WELLNESS, PLLC
Entity type:Organization
Organization Name:ADAPTIVE WELLNESS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:
Authorized Official - Last Name:BATES
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:207-331-5132
Mailing Address - Street 1:1 NEW HAMPSHIRE AVE STE 125
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:NH
Mailing Address - Zip Code:03801-2907
Mailing Address - Country:US
Mailing Address - Phone:207-331-5132
Mailing Address - Fax:833-664-2446
Practice Address - Street 1:1 NEW HAMPSHIRE AVE STE 125
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:NH
Practice Address - Zip Code:03801-2907
Practice Address - Country:US
Practice Address - Phone:207-331-5132
Practice Address - Fax:833-664-2446
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-29
Last Update Date:2023-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty