Healthcare Provider Details

I. General information

NPI: 1174042675
Provider Name (Legal Business Name): LESLEE SMITH MAHON LCPC-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/15/2017
Last Update Date: 01/11/2026
Certification Date: 01/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 371
DANFORTH ME
04424-0371
US

IV. Provider business mailing address

PO BOX 371
DANFORTH ME
04424-0371
US

V. Phone/Fax

Practice location:
  • Phone: 207-227-5792
  • Fax: 207-292-2747
Mailing address:
  • Phone: 207-227-5792
  • Fax: 207-292-2747

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberCC5911
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: