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NPI Code Detail

MEDICARE: COURTNEY A. KANE LCPC, LADC

MEDICARE: COURTNEY A. KANE LCPC, 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
1101YA0400XAddiction (Substance Use Disorder) CounselorLC5971ME
2101YM0800XMental Health CounselorCC4700ME

General Provider Information

NPI Number : 1487060919
Entity Type Code : Individual
Provider Name (Legal Business Name) : COURTNEY A. KANE LCPC, LADC
Provider Business Mailing Address
First Line : 98 MAINE ST STE 5
Second Line :
City : BRUNSWICK
State : ME
Zip : 04011-2031
Country : US
Telephone Number : 207-522-5066
Fax Number :
Provider Business Practice Location Address
First Line : 98 MAINE ST
Second Line : THE LINCOLN BUILDING
City : BRUNSWICK
State : ME
Zip : 04011-2031
Country : US
Telephone Number : 207-522-5066
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/03/2014
Last Update Date : 07/27/2021

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