Individual
TRAVIS C DUREPO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCPC CONDITIONAL
Contact information
Practice address
658 MAIN ST STE 1, CARIBOU, ME 04736-4461
(207) 492-9003
(855) 553-6925
Mailing address
658 MAIN ST STE 1, CARIBOU, ME 04736-4461
(207) 492-0903
(855) 553-6925
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
XL4038
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CC5725
STATE OF MAINE
ME
Enumeration date
09/26/2012
Last updated
12/01/2021
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