| Beau Regards: A Holistic Mental Health Provider Llc | |
|
11 Ohio St Bangor ME 04401-4760 | |
| (207) 517-9898 | |
| Not Available |
| Full Name | Beau Regards: A Holistic Mental Health Provider Llc |
|---|---|
| Speciality | Counselor |
| Location | 11 Ohio St, Bangor, Maine |
| Authorized Official Name and Position | Courtney Lee Beauregard (COUNSELOR) |
| Authorized Official Contact | 2075179898 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Beau Regards: A Holistic Mental Health Provider Llc 11 Ohio St Bangor ME 04401-4760 Ph: (508) 250-3733 | Beau Regards: A Holistic Mental Health Provider Llc 11 Ohio St Bangor ME 04401-4760 Ph: (207) 517-9898 |
| NPI Number | 1710751482 |
|---|---|
| Provider Enumeration Date | 11/13/2023 |
| Last Update Date | 11/13/2023 |
| Certification Date | 11/13/2023 |
| Medicare PECOS PAC ID | 0345687679 |
|---|---|
| Medicare Enrollment ID | O20240322001360 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710751482 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
| Provider Name | Courtney Lee Beauregard |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1922257518 PECOS PAC ID: 4981041217 Enrollment ID: I20240322002061 |
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