Healthcare Provider Details

I. General information

NPI: 1235061193
Provider Name (Legal Business Name): LAURA PENLEY-BEAUDOIN LMSW-CC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/02/2026
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

476 MAIN ST
OXFORD ME
04270-3138
US

IV. Provider business mailing address

1059 CENTER MINOT HILL RD
MINOT ME
04258-4239
US

V. Phone/Fax

Practice location:
  • Phone: 207-897-9000
  • Fax: 207-520-2373
Mailing address:
  • Phone: 207-897-9000
  • Fax: 207-520-2373

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberMC26021
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: