Individual
BETH THIBAULT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCPC
Contact information
Practice address
110 MAIN ST STE 1508, SACO, ME 04072-3517
(207) 494-8016
(207) 494-8640
Mailing address
110 MAIN ST STE 1508, SACO, ME 04072-3517
(207) 494-8016
(207) 494-8640
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
CC3993
ME
101YP2500X
Professional Counselor
XL3377
ME
Other
Enumeration date
12/06/2012
Last updated
11/04/2020
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