Provider Demographics
NPI:1598439960
Name:HEBERT, PEYTON LEE (LCPC)
Entity Type:Individual
Prefix:
First Name:PEYTON
Middle Name:LEE
Last Name:HEBERT
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 1:12 BOLDUC AVE
Mailing Address - Street 2:
Mailing Address - City:FORT KENT
Mailing Address - State:ME
Mailing Address - Zip Code:04743-1602
Mailing Address - Country:US
Mailing Address - Phone:207-728-3971
Mailing Address - Fax:
Practice Address - Street 1:12 BOLDUC AVE
Practice Address - Street 2:
Practice Address - City:FORT KENT
Practice Address - State:ME
Practice Address - Zip Code:04743-1602
Practice Address - Country:US
Practice Address - Phone:207-728-3971
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-09
Last Update Date:2021-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEXL6287101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health