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NPI Code Detail

MEDICARE: SYLVIO DUBOIS LADC

MEDICARE: SYLVIO DUBOIS LADC
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) CounselorLADC #3924ME
2101Y00000XCounselorLC3924ME

General Provider Information

NPI Number : 1659412526
Entity Type Code : Individual
Provider Name (Legal Business Name) : SYLVIO DUBOIS LADC
Provider Business Mailing Address
First Line : 180 ACADEMY ST STE 3
Second Line :
City : PRESQUE ISLE
State : ME
Zip : 04769-3183
Country : US
Telephone Number : 207-554-2352
Fax Number : 207-554-2351
Provider Business Practice Location Address
First Line : 382 MAIN ST
Second Line :
City : LIMESTONE
State : ME
Zip : 04750-6607
Country : US
Telephone Number : 207-325-4727
Fax Number : 72-325-4308
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/12/2007
Last Update Date : 02/02/2021

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