Healthcare Provider Details

I. General information

NPI: 1588548291
Provider Name (Legal Business Name): ELISABETH LUCRETIA LOVIN LCPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/05/2025
Last Update Date: 08/05/2025
Certification Date: 08/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

86 TANDBERG TRL
WINDHAM ME
04062-5841
US

IV. Provider business mailing address

86 TANDBERG TRL
WINDHAM ME
04062-5841
US

V. Phone/Fax

Practice location:
  • Phone: 207-893-0386
  • Fax:
Mailing address:
  • Phone: 207-893-0386
  • Fax: 207-893-2086

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberXL7543
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: