Healthcare Provider Details
I. General information
NPI: 1487769758
Provider Name (Legal Business Name): JOHN LUCIEN GIGUERE LCPC/LADC
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 08/20/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
30 HIGH ST
SKOWHEGAN ME
04976-1828
US
IV. Provider business mailing address
30 HIGH ST
SKOWHEGAN ME
04976-1828
US
V. Phone/Fax
- Phone: 207-474-8368
- Fax: 207-474-7794
- Phone: 207-474-8368
- Fax: 207-474-7794
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YA0400X |
| Taxonomy | Addiction (Substance Use Disorder) Counselor |
| License Number | LC907 |
| License Number State | ME |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101YP2500X |
| Taxonomy | Professional Counselor |
| License Number | CC1557 |
| License Number State | ME |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: