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General NPI Number Information
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NPI Number | 1588647838
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Entity Type | Individual
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Provider Name | DAVID E.A. PRESUTTE LCPC
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Gender | Male
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Dates
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Enumeration Date | 11/21/2005
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 629 MAIN ST
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City | BANGOR
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State | ME
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Zip | 04401-6848
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Country | US
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Telephone | 207-942-6387
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Fax | 207-990-2298
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Provider Business Mailing Address
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Address Line | PO BOX 1785
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City | BANGOR
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State | ME
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Zip | 04402-1785
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Country | US
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Telephone | 207-942-6387
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Fax | 207-990-2298
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | CC3102
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License Number State | ME
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