Provider Demographics
NPI:1689880643
Name:CHARETTE, CATHERINE (LCPC)
Entity Type:Individual
Prefix:MS
First Name:CATHERINE
Middle Name:
Last Name:CHARETTE
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 1:89 BUGBEE RD
Mailing Address - Street 2:
Mailing Address - City:DEXTER
Mailing Address - State:ME
Mailing Address - Zip Code:04930-2421
Mailing Address - Country:US
Mailing Address - Phone:207-947-0366
Mailing Address - Fax:207-947-2825
Practice Address - Street 1:42 CEDAR ST
Practice Address - Street 2:
Practice Address - City:BANGOR
Practice Address - State:ME
Practice Address - Zip Code:04401-6433
Practice Address - Country:US
Practice Address - Phone:207-947-0366
Practice Address - Fax:207-947-2825
Is Sole Proprietor?:No
Enumeration Date:2007-05-15
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECC1916101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional