MEDICARE: STEPHANIE LEE CATER 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	CC1910	ME

General Provider Information

NPI Number	:	1609906320
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEPHANIE LEE CATER LCPC

Provider Business Mailing Address
First Line	:	111 SUMMIT PARK AVE
Second Line	:
City	:	PORTLAND
State	:	ME
Zip	:	04103-2821
Country	:	US
Telephone Number	:	207-939-0114
Fax Number	:

Provider Business Practice Location Address
First Line	:	49 ATLANTIC PL
Second Line	:
City	:	SOUTH PORTLAND
State	:	ME
Zip	:	04106-2316
Country	:	US
Telephone Number	:	207-756-8408
Fax Number	:

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

Provider Enumeration Date	:	03/06/2007
Last Update Date	:	09/12/2018

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