Provider Demographics
NPI:1861922478
Name:TOOTHAKER, SETH
Entity type:Individual
Prefix:MR
First Name:SETH
Middle Name:
Last Name:TOOTHAKER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:53 NORTH ST
Mailing Address - Street 2:
Mailing Address - City:MECHANIC FALLS
Mailing Address - State:ME
Mailing Address - Zip Code:04256-6309
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:53 NORTH ST
Practice Address - Street 2:
Practice Address - City:MECHANIC FALLS
Practice Address - State:ME
Practice Address - Zip Code:04256-6309
Practice Address - Country:US
Practice Address - Phone:207-402-2404
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-15
Last Update Date:2025-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECC5320101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional