Healthcare Provider Details

I. General information

NPI: 1093176844
Provider Name (Legal Business Name): MR. RICHARD J. LARRABEE
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/08/2016
Last Update Date: 05/13/2026
Certification Date: 05/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16 COMMERCE PLZ
WINTHROP ME
04364-1498
US

IV. Provider business mailing address

312 TOWN HOUSE RD
CHELSEA ME
04330-1122
US

V. Phone/Fax

Practice location:
  • Phone: 207-377-2111
  • Fax: 207-624-3845
Mailing address:
  • Phone: 207-458-5257
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberXL4930
License Number StateME
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberLC6923
License Number StateME
# 3
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberCC5827
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: