Healthcare Provider Details

I. General information

NPI: 1184457442
Provider Name (Legal Business Name): SUNSTONE COUNSELING AND CONSULTATION LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/22/2024
Last Update Date: 10/30/2024
Certification Date: 10/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

63 WILKINS RD
GREENE ME
04236-3318
US

IV. Provider business mailing address

63 WILKINS RD
GREENE ME
04236-3318
US

V. Phone/Fax

Practice location:
  • Phone: 207-689-8709
  • Fax:
Mailing address:
  • Phone: 207-689-8709
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: SANDRA LALIBERTE
Title or Position: CLINICIAN
Credential: LCPC
Phone: 207-440-7371