MEDICARE: MRS. DENISE C MAILHOT LADC

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	LC4073	ME

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1275693079
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. DENISE C MAILHOT LADC

Provider Business Mailing Address
First Line	:	67 ROSEDALE ST
Second Line	:
City	:	LEWISTON
State	:	ME
Zip	:	04240-6133
Country	:	US
Telephone Number	:	207-786-3380
Fax Number	:

Provider Business Practice Location Address
First Line	:	188 LINCOLN ST
Second Line	:
City	:	LEWISTON
State	:	ME
Zip	:	04240-7814
Country	:	US
Telephone Number	:	207-513-8843
Fax Number	:	207-241-8318

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

Provider Enumeration Date	:	12/11/2006
Last Update Date	:	12/01/2025

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