MS. ALISON MOORE TETRAULT (NPI# 1851935878) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1851935878 |
| Entity Type | Individual |
| Full Name | MS. ALISON MOORE TETRAULT |
| Credential | RN, PMHNP-BC |
| Practice Address |
66 State St Portland ME 04101-3751 |
| Mailing Address |
420 Cumberland Ave Portland ME 04101-2823 |
| Practice Telephone | 2078717431 |
| Mailing Telephone | 2078717431 |
| Enumeration Date | 2019-11-01 |
| Last Update Date | 2020-03-13 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163WP0808X |
Registered Nurse Specialization: Psych/Mental Health |
68812 | ME | Nursing Service Providers |
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
CNP201021 | ME | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
66 STATE ST |
| City | PORTLAND |
| State | ME |
| Zip Code | 04101-3751 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578631123 | Peter Steven Sentner | Social Worker | 66 State St, Portland, ME 04101-3751 | 2006-12-01 |
| 1801427893 | Maria Beauregard | Counselor | 66 State St, Portland, ME 04101-3751 | 2020-01-29 |
| 1831749761 | Rachel Paula Saltzman | Social Worker | 66 State St, Portland, ME 04101-3751 | 2019-09-12 |
| 1073960753 | Jeff Tiner | Social Worker | 66 State St, Portland, ME 04101-3751 | 2016-05-23 |
| 1811358054 | Gwendolyne Elissa Tuttle | Social Worker | 66 State St, Portland, ME 04101-3751 | 2016-03-16 |
| 1750747952 | Abigail Leah Spadone | Social Worker | 66 State St, Portland, ME 04101-3751 | 2016-01-05 |
| 1609241975 | Brian Maynard Townsend | Counselor | 66 State St, Portland, ME 04101-3751 | 2015-12-11 |
| 1336514710 | Amanda Mcpheters | Social Worker | 66 State St, Portland, ME 04101-3751 | 2015-12-10 |
| 1497139968 | Emily Lusenhop | Social Worker | 66 State St, Portland, ME 04101-3751 | 2015-07-15 |
| 1275963886 | Brook Sawyer | Counselor | 66 State St, Portland, ME 04101-3751 | 2013-11-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306450655 | Jocylin Egan | Nurse Practitioner | 442 Congress Street, 2nd Floor, Portland, ME 04101 | 2020-09-03 |
| 1255963559 | Portcity Home Healthcare LLC | In Home Supportive Care | 525 Forest Avenue, Suite 8, Portland, ME 04101 | 2020-02-05 |
| 1578101929 | Mohamed Hassan Mohamed | Student in an Organized Health Care Education/Training Program | 75 Lancaster St Ste 218a, Portland, ME 04101 | 2019-12-17 |
| 1841855301 | Portland Opioid Health Home | Counselor | 48 Free St., Mezzanine Level, Portland, ME 04101 | 2019-05-09 |
| 1093379224 | Alexandra Strawbridge Maurer | Acupuncturist | 50 A Cove Street, Portland, ME 04101 | 2019-04-23 |
| 1245719541 | Scott J Whited | Nurse Practitioner | 216 Vaughan St., Mcgeachy Hall, Portland, ME 04101 | 2018-08-08 |
| 1144733064 | Alixandria Elaine Marie Winchell | Massage Therapist | One City Center, Portland, ME 04101 | 2017-11-14 |
| 1417473638 | Rachel S Schwaner | Occupational Therapist | 78 Danforth Street, Apartment 6, Portland, ME 04101 | 2017-08-18 |
| 1023538154 | Derina Boothroyd | Audiologist-Hearing Aid Fitter | 985 Forest Ave., Portland, ME 04101 | 2017-06-20 |
| 1881123297 | Mark Mccullough | Social Worker | 57 Exchange Street, Suite 403, Portland, ME 04101 | 2017-06-08 |
| Find all providers in zip 04101 | ||||
| Taxonomy Code | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
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| 1457967325 | Megan L Langworthy | Nurse Practitioner | 1914 Se 46th Ave, Portland, OR 97215-3148 | 2020-09-16 |
| 1104446681 | Skycloud Psychiatry LLC | Nurse Practitioner | 106 South West Woods St, Portland, OR 97201 | 2020-04-24 |
| 1730712290 | Lucy Anne Bloedon | Nurse Practitioner | 4020 Sw Iowa St, Portland, OR 97221-3423 | 2020-02-12 |
| 1346802733 | Compass Psychiatric Wellness LLC | Nurse Practitioner | 4300 Ne Fremont St Ste 260, Portland, OR 97213-1100 | 2019-07-05 |
| 1548721871 | Cooke Therapy Pllc | Nurse Practitioner | 1125 Se Madison St Ste 102, Portland, OR 97214-3600 | 2019-03-28 |
| 1245719541 | Scott J Whited | Nurse Practitioner | 216 Vaughan St., Mcgeachy Hall, Portland, ME 04101 | 2018-08-08 |
| 1467969220 | Nw Mind-body Wellness, LLC | Nurse Practitioner | 16986 Nw Lynch Ln, Portland, OR 97229-1221 | 2018-01-02 |
| 1811441348 | Anthony Hoy | Nurse Practitioner | 5562 Se Pine St, Portland, OR 97215-1276 | 2016-08-12 |
| 1700241254 | Jacqueline J Cole | Nurse Practitioner | 5228 Ne Hoyt St Ste 300, Portland, OR 97213-3055 | 2015-12-29 |
| Find all providers in PORTLAND | ||||
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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.