Individual
KIMBERLY CLARK CHABOT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCPC
Contact information
Practice address
893 PORTLAND RD, UNIT 5, SACO, ME 04072
(207) 829-5099
Mailing address
893 PORTLAND RD, UNIT 5, SACO, ME 04072
(207) 829-5099
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
CC3785
ME
101YM0800X
Mental Health Counselor
CC3785
ME
101YP2500X
Professional Counselor
Primary
CC3785
ME
103K00000X
Behavior Analyst
CC3785
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
30989
NCC
ME
01
—
CC3785
LCPC
ME
Enumeration date
06/22/2011
Last updated
12/20/2024
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