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NPI Code Detail

MEDICARE: KEVIN MICHAEL MCKEOWN LCPC

MEDICARE: KEVIN MICHAEL MCKEOWN 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
1101YP2500XProfessional CounselorXL6877ME
2101YP2500XProfessional CounselorCC8025ME

General Provider Information

NPI Number : 1447945332
Entity Type Code : Individual
Provider Name (Legal Business Name) : KEVIN MICHAEL MCKEOWN LCPC
Provider Business Mailing Address
First Line : 67 EUSTIS PKWY
Second Line :
City : WATERVILLE
State : ME
Zip : 04901-5173
Country : US
Telephone Number : 207-873-2136
Fax Number : 207-660-4529
Provider Business Practice Location Address
First Line : 53 BAXTER BLVD STE 3
Second Line :
City : PORTLAND
State : ME
Zip : 04101-1827
Country : US
Telephone Number : 603-883-0005
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/07/2023
Last Update Date : 05/27/2026

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Directions to “ KEVIN MICHAEL MCKEOWN LCPC” Practice Location

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