Provider Demographics
NPI:1710387790
Name:BLANCHETTE, STEVE (MHRT-CSP)
Entity Type:Individual
Prefix:
First Name:STEVE
Middle Name:
Last Name:BLANCHETTE
Suffix:
Gender:M
Credentials:MHRT-CSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 MILL ST
Mailing Address - Street 2:
Mailing Address - City:HOULTON
Mailing Address - State:ME
Mailing Address - Zip Code:04730-1877
Mailing Address - Country:US
Mailing Address - Phone:207-532-6523
Mailing Address - Fax:207-532-3873
Practice Address - Street 1:11 MILL ST
Practice Address - Street 2:
Practice Address - City:HOULTON
Practice Address - State:ME
Practice Address - Zip Code:04730-1877
Practice Address - Country:US
Practice Address - Phone:207-532-6523
Practice Address - Fax:207-532-3873
Is Sole Proprietor?:No
Enumeration Date:2014-08-27
Last Update Date:2014-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME1710387790Medicaid