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NPI Code Detail

MEDICARE: RONAN JOY AUBREY LCPC

MEDICARE:   RONAN JOY AUBREY  LCPC
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
1101YM0800XMental Health CounselorCC7445ME

General Provider Information

NPI Number : 1922610161
Entity Type Code : Individual
Provider Name (Legal Business Name) : RONAN JOY AUBREY LCPC
Provider Business Mailing Address
First Line : 500 FOREST AVE STE 5D
Second Line :
City : PORTLAND
State : ME
Zip : 04101-1520
Country : US
Telephone Number : 207-450-3912
Fax Number :
Provider Business Practice Location Address
First Line : 500 FOREST AVE STE 5D
Second Line :
City : PORTLAND
State : ME
Zip : 04101-1520
Country : US
Telephone Number : 207-450-3912
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/19/2020
Last Update Date : 05/15/2025

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Directions to “ RONAN JOY AUBREY LCPC” Practice Location

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