Healthcare Provider Details

I. General information

NPI: 1306763354
Provider Name (Legal Business Name): DOUGLAS TOWLE LCPC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/01/2026
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

878 MAIN ST
PALMYRA ME
04965-3409
US

IV. Provider business mailing address

878 MAIN ST
PALMYRA ME
04965-3409
US

V. Phone/Fax

Practice location:
  • Phone: 207-341-0938
  • Fax:
Mailing address:
  • Phone: 207-341-0938
  • 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: DOUGLAS EDMOND TOWLE
Title or Position: OWNER
Credential: LCPC
Phone: 207-341-0938