MEDICARE: JULIE L ALLEN LCPC

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	101YP2500X	Professional Counselor	XL3484	ME
2	101YP2500X	Professional Counselor	CC4037	ME

General Provider Information

NPI Number	:	1154643369
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JULIE L ALLEN LCPC

Provider Business Mailing Address
First Line	:	62 PORTLAND RD STE 46
Second Line	:
City	:	KENNEBUNK
State	:	ME
Zip	:	04043-6650
Country	:	US
Telephone Number	:	207-468-0298
Fax Number	:	207-604-5000

Provider Business Practice Location Address
First Line	:	62 PORTLAND RD STE 46
Second Line	:
City	:	KENNEBUNK
State	:	ME
Zip	:	04043-6650
Country	:	US
Telephone Number	:	207-468-0298
Fax Number	:	207-604-5000

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

Provider Enumeration Date	:	02/16/2010
Last Update Date	:	07/21/2022

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