Provider Demographics
NPI:1861804064
Name:RESILIENCE COUNSELING SERVICES LLC
Entity type:Organization
Organization Name:RESILIENCE COUNSELING SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JOANNA
Authorized Official - Middle Name:C
Authorized Official - Last Name:BULGER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:207-228-5080
Mailing Address - Street 1:PO BOX 920
Mailing Address - Street 2:
Mailing Address - City:BUXTON
Mailing Address - State:ME
Mailing Address - Zip Code:04093-0920
Mailing Address - Country:US
Mailing Address - Phone:207-228-5080
Mailing Address - Fax:
Practice Address - Street 1:55 FOGG RD
Practice Address - Street 2:
Practice Address - City:BUXTON
Practice Address - State:ME
Practice Address - Zip Code:04093-3614
Practice Address - Country:US
Practice Address - Phone:207-228-5080
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-22
Last Update Date:2014-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELC60351041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty