Healthcare Provider Details

I. General information

NPI: 1922937622
Provider Name (Legal Business Name): KATHLEEN WILBER LCPC-C, ATR-P
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: KATIE WILBER LCPC-C, ATR-P

II. Dates (important events)

Enumeration Date: 05/18/2026
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

707 SABLE OAKS DR STE 10
SOUTH PORTLAND ME
04106-6954
US

IV. Provider business mailing address

8 TYLER DR APT 2
WESTBROOK ME
04092-3076
US

V. Phone/Fax

Practice location:
  • Phone: 207-600-4344
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberXL8822
License Number StateME
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberXL8822
License Number StateME
# 3
Primary TaxonomyN
Taxonomy Code221700000X
TaxonomyArt Therapist
License Number25426
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: