Healthcare Provider Details

I. General information

NPI: 1053235242
Provider Name (Legal Business Name): JAVARIS LEVON CARRIGAN MS/LCPC-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/08/2026
Last Update Date: 08/08/2026
Certification Date: 08/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1190 LISBON ST
LEWISTON ME
04240-5063
US

IV. Provider business mailing address

1190 LISBON ST
LEWISTON ME
04240-5063
US

V. Phone/Fax

Practice location:
  • Phone: 207-376-4880
  • Fax: 207-241-0629
Mailing address:
  • Phone: 207-376-4880
  • Fax: 207-241-0629

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberXL8903
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: