MEDICARE: BREK HEIKKINEN LCPC-C

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	101YM0800X	Mental Health Counselor	XL8775	ME

General Provider Information

NPI Number	:	1700717592
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BREK HEIKKINEN LCPC-C

Provider Business Mailing Address
First Line	:	418 WOODFORD ST
Second Line	:
City	:	PORTLAND
State	:	ME
Zip	:	04103-2460
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	500 FOREST AVE STE 9
Second Line	:
City	:	PORTLAND
State	:	ME
Zip	:	04101-1520
Country	:	US
Telephone Number	:	207-420-7700
Fax Number	:

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

Provider Enumeration Date	:	05/28/2026
Last Update Date	:	05/28/2026

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Directions to “ BREK HEIKKINEN LCPC-C” Practice Location

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