Healthcare Provider Details

I. General information

NPI: 1033488556
Provider Name (Legal Business Name): LIFE LESSONS PSYCHIATRIC SERVICES, SC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/29/2011
Last Update Date: 12/29/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

61 MAIN ST SUITE 53
BANGOR ME
04401-6397
US

IV. Provider business mailing address

61 MAIN ST SUITE 53
BANGOR ME
04401-6397
US

V. Phone/Fax

Practice location:
  • Phone: 207-208-8301
  • Fax: 877-320-4344
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number StateME

VIII. Authorized Official

Name: MRS. MELISSA CHARETTE
Title or Position: OWNER
Credential: PMHNP-BC
Phone: 207-208-8301