Healthcare Provider Details

I. General information

NPI: 1376190173
Provider Name (Legal Business Name): ALLISON LESLIE HART LCPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/26/2019
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7 OAK HILL TER STE 211
SCARBOROUGH ME
04074-7912
US

IV. Provider business mailing address

21 CHRISTIAN ROW
BUXTON ME
04093-3151
US

V. Phone/Fax

Practice location:
  • Phone: 207-332-0336
  • Fax:
Mailing address:
  • Phone: 207-332-0336
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberCC6219
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: