Provider Demographics
NPI:1568710044
Name:SPRAGUE, NOREEN ELLEN (LCPC)
Entity Type:Individual
Prefix:
First Name:NOREEN
Middle Name:ELLEN
Last Name:SPRAGUE
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:PO BOX 56
Mailing Address - Street 2:
Mailing Address - City:EAST DIXFIELD
Mailing Address - State:ME
Mailing Address - Zip Code:04227-0056
Mailing Address - Country:US
Mailing Address - Phone:207-491-6425
Mailing Address - Fax:
Practice Address - Street 1:76 EAST DIXFIELD RD
Practice Address - Street 2:
Practice Address - City:EAST DIXFIELD
Practice Address - State:ME
Practice Address - Zip Code:04227
Practice Address - Country:US
Practice Address - Phone:207-491-6425
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-15
Last Update Date:2023-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEXL3950101YP2500X
MECC4328101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional