Healthcare Provider Details

I. General information

NPI: 1437719721
Provider Name (Legal Business Name): CHRISTINA DAWN WILLEY CADC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CHRISTINA LEVESQUE

II. Dates (important events)

Enumeration Date: 06/18/2019
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7 OAK HILL TER STE 205
SCARBOROUGH ME
04074-8996
US

IV. Provider business mailing address

111 S BEDFORD ST STE 205
BURLINGTON MA
01803-5145
US

V. Phone/Fax

Practice location:
  • Phone: 866-679-0831
  • Fax:
Mailing address:
  • Phone: 800-683-8313
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberCAC6488
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: