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NPI Code Detail

MEDICARE: PATRICIA PROULX-LOUGH COUNSELING, PLLC

MEDICARE: PATRICIA PROULX-LOUGH COUNSELING, PLLC
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
1106H00000XMarriage & Family Therapist

General Provider Information

NPI Number : 1336628049
Entity Type Code : Organization
Provider Name (Legal Business Name) : PATRICIA PROULX-LOUGH COUNSELING, PLLC
Provider Business Mailing Address
First Line : 9 HASTINGS ST
Second Line :
City : PORTLAND
State : ME
Zip : 04102-2015
Country : US
Telephone Number : 207-530-8534
Fax Number : 207-221-1065
Provider Business Practice Location Address
First Line : 9 HASTINGS ST
Second Line :
City : PORTLAND
State : ME
Zip : 04102-2015
Country : US
Telephone Number : 207-530-8534
Fax Number : 207-221-1065
Authorized Official
Title or Position : PRESIDENT/OWNER
Name : MS. PATRICIA ANNE PROULX-LOUGH
Credential : L.M.F.T.
Telephone Number : 207-766-1053
Provider Enumeration Date : 08/13/2018
Last Update Date : 08/13/2018

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