Healthcare Provider Details

I. General information

NPI: 1891663225
Provider Name (Legal Business Name): APRIL THIBODEAU
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/27/2025
Last Update Date: 10/27/2025
Certification Date: 10/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1182 DOVER RD
CHARLESTON ME
04422-3031
US

IV. Provider business mailing address

1072 SUNSET AVE
GLENBURN ME
04401-1423
US

V. Phone/Fax

Practice location:
  • Phone: 207-285-0880
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberCAC7412
License Number StateME
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLC18793
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: