Provider Demographics
NPI:1811226087
Name:MAITRI PSYCHOTHERAPY ASSOCIATES LLC
Entity type:Organization
Organization Name:MAITRI PSYCHOTHERAPY ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER/PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:DAWN
Authorized Official - Middle Name:
Authorized Official - Last Name:LESNESKI
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LCPC
Authorized Official - Phone:207-363-8300
Mailing Address - Street 1:433 US ROUTE 1
Mailing Address - Street 2:COTTAGE PLACE, SUITE 204
Mailing Address - City:YORK
Mailing Address - State:ME
Mailing Address - Zip Code:03909-1659
Mailing Address - Country:US
Mailing Address - Phone:207-363-8300
Mailing Address - Fax:207-363-8301
Practice Address - Street 1:433 US ROUTE 1 STE 204
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:ME
Practice Address - Zip Code:03909-1647
Practice Address - Country:US
Practice Address - Phone:207-363-8300
Practice Address - Fax:207-218-0316
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-16
Last Update Date:2024-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME432296899Medicaid