MR. TRISTAN OLIVER GREENLAW (NPI# 1811471766) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811471766 |
| Entity Type | Individual |
| Full Name | MR. TRISTAN OLIVER GREENLAW |
| Credential | LCPC-C |
| Practice Address |
9 Central St Ste 401 Bangor ME 04401-5168 |
| Mailing Address |
155 Court St Bangor ME 04401-4725 |
| Practice Telephone | 2079227572 |
| Practice Fax Number | 8555494878 |
| Mailing Telephone | 2079227572 |
| Enumeration Date | 2018-09-17 |
| Last Update Date | 2020-04-07 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
XL5121 | ME | Behavioral Health & Social Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 61 Main St Ste 35, Bangor, ME 044018300 | 2079227572 |
| Street Address |
9 CENTRAL ST STE 401 |
| City | BANGOR |
| State | ME |
| Zip Code | 04401-5168 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184222523 | Bj's Wholesale Club Inc. | Eyewear Supplier (Equipment, not the service) | 110 Longview Dr, Bangor, ME 04401 | 2020-10-16 |
| 1033737937 | Daniel John Phulman | Counselor | 202 Exchange Street, Bangor, ME 04401 | 2020-07-08 |
| 1770104358 | Elizabeth Sarah Caruson | Physician Assistant | 417 State Street Webber Medical Building, East St, Ste. 121, Bangor, ME 04401 | 2020-05-05 |
| 1053961300 | Erika Dean | Occupational Therapist | 84 Sylvan Rd., Bangor, ME 04401 | 2019-09-18 |
| 1942853635 | Wildworks Therapy, Pllc | Occupational Therapist | 123 Mt Hope Ave, Bangor, ME 04401 | 2019-07-22 |
| 1255999173 | Jessica Arbisi | Physician Assistant | 1 Northeast Drive, Bangor, ME 04401 | 2019-06-05 |
| 1699232041 | Ehab Khamis Elhefnawi | Anesthesiology | Emmc Anesthesia Professional Service, 489 State Street, Bangor, ME 04401 | 2019-02-21 |
| 1477028884 | Zvorufura Makura | Otolaryngology | 885 Union Street, Ste 145, Bangor, ME 04401 | 2018-10-11 |
| 1255826541 | Lindsey M Fields | Optometrist | 955 Broadway Eye Center Northeast Dba Northeast Eyecare, Bangor, ME 04401 | 2018-06-28 |
| 1992211338 | Debra J Mcintyre | Counselor | 157 Park Street, #5, Bangor, ME 04401 | 2017-12-21 |
| Find all providers in zip 04401 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033737937 | Daniel John Phulman | Counselor | 202 Exchange Street, Bangor, ME 04401 | 2020-07-08 |
| 1104476811 | Janet May | Counselor | 49 16th St, Bangor, ME 04401-3122 | 2019-09-14 |
| 1699257782 | Jesse Robinson Call | Counselor | 304 Hancock St Ste 3b, Bangor, ME 04401-6573 | 2018-09-05 |
| 1225551203 | Macy Marie Pelletier | Counselor | 30 Summer St Ste 5, Bangor, ME 04401-6467 | 2017-07-20 |
| 1356680995 | Kaleigh Marie Dupuis | Counselor | 43 Columbia St Ste 12, Bangor, ME 04401-6346 | 2013-02-01 |
| 1063651792 | Tamara J Hunt | Counselor | 31 Central St Ste 201, Bangor, ME 04401-5146 | 2009-02-19 |
| 1093872327 | Keith Laplante | Counselor | 70 E Broadway, Bangor, ME 04401-3425 | 2007-01-03 |
| 1003971912 | Debbie Lynn Webber | Counselor | 24 Springer Road, 1 Springer Place Suite 202, Bangor, ME 04401 | 2006-12-22 |
| 1871676890 | Robin V Hamilton | Counselor | 304 Hancock St Ste 2b, Families and Children Together, Bangor, ME 04401-6573 | 2006-10-23 |
| 1467569129 | June Winifred Doody | Counselor | 100 Ridgewood Dr, Bangor, ME 04401-2652 | 2006-08-25 |
| Find all providers in BANGOR | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.