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General NPI Number Information
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NPI Number | 1902232127
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Entity Type | Organization
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Legal Business Name | LEEWARD COUNSELING LLC
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Dates
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Enumeration Date | 09/19/2013
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Last Update Date | 01/05/2015
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Provider Practice Location Address
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Address Line | 25 MAIN ST SUITE 2
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City | MACHIAS
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State | ME
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Zip | 04654-1165
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Country | US
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Telephone | 207-271-8105
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Fax |
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Provider Business Mailing Address
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Address Line | 25 MAIN ST SUITE 2
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City | MACHIAS
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State | ME
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Zip | 04654-1165
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Country | US
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Telephone | 207-271-8105
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | LAURA LANDRY
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Credential | LCSW
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Telephone | 207-271-8105
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | LC13426
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License Number State | ME
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