Provider Demographics
NPI:1366461501
Name:PILLSBURY, ELECIA CHRISTINE (LCPC)
Entity Type:Individual
Prefix:
First Name:ELECIA
Middle Name:CHRISTINE
Last Name:PILLSBURY
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 1:8 PINE AVE
Mailing Address - Street 2:
Mailing Address - City:LIVERMORE FALLS
Mailing Address - State:ME
Mailing Address - Zip Code:04254-1330
Mailing Address - Country:US
Mailing Address - Phone:207-897-2871
Mailing Address - Fax:
Practice Address - Street 1:1 DEPOT ST
Practice Address - Street 2:SUITE C
Practice Address - City:LIVERMORE FALLS
Practice Address - State:ME
Practice Address - Zip Code:04254-1331
Practice Address - Country:US
Practice Address - Phone:207-897-2871
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-19
Last Update Date:2009-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECC1930101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME229430099Medicaid
ME87726OtherUNITED BEHAVIORAL HEALTH
ME039958OtherANTHEM B/C B/S
ME271330000OtherMAGELLAN
ME7512281OtherAETNA