Provider Demographics
NPI:1356680995
Name:DUPUIS, KALEIGH MARIE (LCPC)
Entity Type:Individual
Prefix:
First Name:KALEIGH
Middle Name:MARIE
Last Name:DUPUIS
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 1:336 MOUNT HOPE AVE STE 14
Mailing Address - Street 2:
Mailing Address - City:BANGOR
Mailing Address - State:ME
Mailing Address - Zip Code:04401-4236
Mailing Address - Country:US
Mailing Address - Phone:207-745-6528
Mailing Address - Fax:207-573-4666
Practice Address - Street 1:336 MOUNT HOPE AVE STE 14
Practice Address - Street 2:
Practice Address - City:BANGOR
Practice Address - State:ME
Practice Address - Zip Code:04401-4236
Practice Address - Country:US
Practice Address - Phone:207-745-6528
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-01
Last Update Date:2021-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECC4452101YM0800X, 101YP2500X
ME101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty