Healthcare Provider Details

I. General information

NPI: 1285542092
Provider Name (Legal Business Name): KATELYN PESCHIER LADC, MHRT/C-P
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

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

III. Provider practice location address

4 HAYFIELD LN
LISBON ME
04250-6899
US

IV. Provider business mailing address

4 HAYFIELD LN
LISBON ME
04250-6899
US

V. Phone/Fax

Practice location:
  • Phone: 857-746-9728
  • Fax:
Mailing address:
  • Phone: 857-746-9728
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberLC9431
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: