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NPI Code Detail

MEDICARE: MRS. KATLYN MARIE FURNESS LADC,CCS

MEDICARE: MRS. KATLYN MARIE FURNESS LADC,CCS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) CounselorLC7668ME
2101YA0400XAddiction (Substance Use Disorder) CounselorCCS8770ME
3101YA0400XAddiction (Substance Use Disorder) CounselorCAC7052ME

General Provider Information

NPI Number : 1639781669
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. KATLYN MARIE FURNESS LADC,CCS
Provider Business Mailing Address
First Line : 217 MAIN ST STE 302
Second Line :
City : LEWISTON
State : ME
Zip : 04240-8193
Country : US
Telephone Number : 207-520-1760
Fax Number :
Provider Business Practice Location Address
First Line : 103 PARK ST
Second Line :
City : LEWISTON
State : ME
Zip : 04240-7203
Country : US
Telephone Number : 207-440-7922
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/20/2020
Last Update Date : 06/12/2025

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