Provider Demographics
NPI:1215437181
Name:ABSOLUTE HAPPINESS PSYCHOTHERAPY AND CONSULTATION
Entity type:Organization
Organization Name:ABSOLUTE HAPPINESS PSYCHOTHERAPY AND CONSULTATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:
Authorized Official - Last Name:TOLBERT
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:207-951-5838
Mailing Address - Street 1:405 WESTERN AVE # 301
Mailing Address - Street 2:
Mailing Address - City:SOUTH PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04106-1705
Mailing Address - Country:US
Mailing Address - Phone:207-951-5838
Mailing Address - Fax:
Practice Address - Street 1:63 FEDERAL ST # 1012
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04101-4222
Practice Address - Country:US
Practice Address - Phone:207-951-5838
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-17
Last Update Date:2024-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELC1701261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)