MEDICARE: JOSEPH LEMIEUX MA, CADC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YA0400X	Addiction (Substance Use Disorder) Counselor	CAC4539	ME

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	CAC4539	OTHER	ME	CERTIFIED ALCOHOL AND DRUG ABUSE COUNSELOR

General Provider Information

NPI Number	:	1093030603
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSEPH LEMIEUX MA, CADC

Provider Business Mailing Address
First Line	:	4 PARK ST
Second Line	:
City	:	LEWISTON
State	:	ME
Zip	:	04240-7172
Country	:	US
Telephone Number	:	207-784-0922
Fax Number	:	207-784-6143

Provider Business Practice Location Address
First Line	:	4 PARK ST
Second Line	:
City	:	LEWISTON
State	:	ME
Zip	:	04240-7172
Country	:	US
Telephone Number	:	207-784-0922
Fax Number	:	207-784-6143

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/07/2010
Last Update Date	:	04/07/2010

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