| Judy Gagnon Counseling Services Llc | |
|
469 Main St Ste 308 Springvale ME 04083-1872 | |
| (207) 698-0475 | |
| (207) 850-1063 |
| Full Name | Judy Gagnon Counseling Services Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 469 Main St Ste 308, Springvale, Maine |
| Authorized Official Name and Position | Judy Gagnon (OWNER) |
| Authorized Official Contact | 2076980475 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Judy Gagnon Counseling Services Llc 64 Merchants Row Lebanon ME 04027-4305 Ph: (207) 698-0475 | Judy Gagnon Counseling Services Llc 469 Main St Ste 308 Springvale ME 04083-1872 Ph: (207) 698-0475 |
| NPI Number | 1417719931 |
|---|---|
| Provider Enumeration Date | 01/29/2024 |
| Last Update Date | 01/29/2024 |
| Certification Date | 01/29/2024 |
| Medicare PECOS PAC ID | 0244674703 |
|---|---|
| Medicare Enrollment ID | O20240223000519 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417719931 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Judy Gagnon |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1700450459 PECOS PAC ID: 1153765615 Enrollment ID: I20240223000639 |
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