Provider Demographics
NPI:1609368877
Name:RECKENDORF, LAURIE MCLEAN (MA, LPC, LCPC, NCC)
Entity Type:Individual
Prefix:MRS
First Name:LAURIE
Middle Name:MCLEAN
Last Name:RECKENDORF
Suffix:
Gender:F
Credentials:MA, LPC, LCPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 JAMESEY COURT
Mailing Address - Street 2:PO BOX 225
Mailing Address - City:NEW HARBOR
Mailing Address - State:ME
Mailing Address - Zip Code:04554
Mailing Address - Country:US
Mailing Address - Phone:207-677-6600
Mailing Address - Fax:
Practice Address - Street 1:16 JAMESEY COURT
Practice Address - Street 2:SUITE 100
Practice Address - City:NEW HARBOR
Practice Address - State:ME
Practice Address - Zip Code:04554
Practice Address - Country:US
Practice Address - Phone:207-677-6600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-04
Last Update Date:2018-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECC4871101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional