Individual
JANICE LAVOIE BUREAU
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
LCSW, ACSW
Contact information
Practice address
444 MAIN ST, LEWISTON, ME 04240-6737
(207) 689-2354
Mailing address
PO BOX 91, KENTS HILL, ME 04349-0091
(207) 689-2354
(207) 689-2354
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LC9674
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
048260
ANTHEM
ME
05
—
247580099
—
ME
01
—
LC9674
STATE LICENSE
ME
Enumeration date
09/09/2005
Last updated
10/03/2017
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