Individual
NICOLA J WEATHERBEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LADC
Contact information
Practice address
28 CONGRESS ST, RUMFORD, ME 04276-2092
(207) 364-1610
(207) 364-1611
Mailing address
28 CONGRESS ST, RUMFORD, ME 04276-2092
(207) 364-1610
(207) 364-1611
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LC4564
ME
101YM0800X
Mental Health Counselor
XL4368
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
433007599
MAINECARE
ME
Enumeration date
09/21/2009
Last updated
08/31/2015
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