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Individual

DOUGLAS D LEVESQUE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LCSW, LADS, CCS

Contact information

Practice address
12 BOLDUC AVE, FORT KENT, ME 04743-1602
(207) 834-3971
(207) 834-3837
Mailing address
12 BOLDUC AVE, FORT KENT, ME 04743-1602
(207) 834-3971
(207) 834-3837

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
CCS4442
ME
1041C0700X
Clinical Social Worker
Primary
LC12734
ME
1041C0700X
Clinical Social Worker
LC3551
ME

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
431555999
ME
Enumeration date
01/29/2007
Last updated
03/17/2021
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