Provider Demographics
NPI:1437719721
Name:LEVESQUE, CHRISTINA DAWN (CADC)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTINA
Middle Name:DAWN
Last Name:LEVESQUE
Suffix:
Gender:F
Credentials:CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:319 STATE STREET
Mailing Address - Street 2:
Mailing Address - City:BANGOR
Mailing Address - State:ME
Mailing Address - Zip Code:04401
Mailing Address - Country:US
Mailing Address - Phone:207-941-1639
Mailing Address - Fax:207-941-1620
Practice Address - Street 1:319 STATE STREET
Practice Address - Street 2:
Practice Address - City:BANGOR
Practice Address - State:ME
Practice Address - Zip Code:04401-0440
Practice Address - Country:US
Practice Address - Phone:207-941-1639
Practice Address - Fax:207-941-1620
Is Sole Proprietor?:No
Enumeration Date:2019-06-18
Last Update Date:2019-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECAC6488101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)