Lisa Favreau, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

AT263 Issued in ME

Practice address

100 Foden Rd
Suite 103W
So Portland, ME 04106-2319

Phone

(207) 772-2625

Fax

(207) 879-4246

NPI assigned

Jun 19, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Saco Bay Orthopaedic and Sports Physical Therapy, Inc.

  • Physical Therapy Clinic/Center
  • Westbrook, ME
  • NPI 1396312807
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1150675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1497790836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 FODEN RD",
            "address_2": "SUITE 103W",
            "city": "SO PORTLAND",
            "state": "ME",
            "postal_code": "041062319",
            "telephone_number": "207-772-2625",
            "fax_number": "207-879-4246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 FODEN RD",
            "address_2": "SUITE 103W",
            "city": "SO PORTLAND",
            "state": "ME",
            "postal_code": "041062319",
            "telephone_number": "207-772-2625",
            "fax_number": "207-879-4246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAVREAU",
        "first_name": "LISA",
        "credential": "ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-19",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "ME",
            "license": "AT263",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Morgen M Buehner, MD
• Tracy Cardelli, R.D.
• Karen Fagan, PTA
• Food Addiction Chemical Dependency Consultants LLC
• Matthew Henry Hayn, M.D.
• Patricia A Lerwick, MD
• James Daniel Miller, M.D.
• Stephen F Osborne, M.D.

• Athletic Trainer in So Portland, ME
• Providers in So Portland, ME by specialty
• Athletic Trainer in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.