Provider Demographics
NPI:1073604997
Name:LAWRENCE, RHONDA ANN (LCPC)
Entity Type:Individual
Prefix:
First Name:RHONDA
Middle Name:ANN
Last Name:LAWRENCE
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 LINCOLN ST
Mailing Address - Street 2:
Mailing Address - City:RANDOLPH
Mailing Address - State:ME
Mailing Address - Zip Code:04346-5140
Mailing Address - Country:US
Mailing Address - Phone:207-441-9837
Mailing Address - Fax:207-622-6290
Practice Address - Street 1:49 OAK ST
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:ME
Practice Address - Zip Code:04330-5118
Practice Address - Country:US
Practice Address - Phone:207-441-9837
Practice Address - Fax:207-622-6290
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECC2599101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME431995099Medicaid