Courtney Lee Beauregard, LPC

Individual provider Active NPI Mental Health Counselor · Bangor, ME

NPI 1922257518 · NPPES record last updated Dec 13, 2023

Key facts

NPI
1922257518
Entity type
Individual (NPI type 1)
Primary specialty
Mental Health Counselor 101YM0800X
Practice address
11 Ohio St
Bangor, ME 04401-4760
Phone
(508) 250-3733
NPI assigned
Sep 18, 2008
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Yes

Addresses

Primary practice location

11 Ohio St
Bangor, ME 04401-4760

Mailing address

11 Ohio St
Bangor, ME 04401-4760
Phone (508) 250-3733

Other identifiers

IdentifierTypeStateIssuer
PC010285OtherPASTATE LICENSE

Electronic endpoints

TypeEndpointUseAffiliation
Other URL Philadelphia Direct

Other providers in Bangor, ME

All providers in Bangor, ME · Mental Health Counselor in Maine

Sources for this page

Verify at the official NPI Registry.