Individual
LISA M CUSHING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CADC
Contact information
Practice address
127 PALMER ST, CALAIS, ME 04619-1300
(207) 498-6431
Mailing address
43 HATCH DR, SUITE 210, CARIBOU, ME 04736-2161
(207) 498-6431
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CAC3653
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
CAC3653
—
ME
Enumeration date
10/09/2015
Last updated
01/11/2017
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