Provider Demographics
NPI:1851519698
Name:DRUCKER, ALLEN (M ED, LCPC)
Entity Type:Individual
Prefix:MR
First Name:ALLEN
Middle Name:
Last Name:DRUCKER
Suffix:
Gender:M
Credentials:M ED, LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 STATE STREET
Mailing Address - Street 2:SUITE 3
Mailing Address - City:BANGOR
Mailing Address - State:ME
Mailing Address - Zip Code:04401-5389
Mailing Address - Country:US
Mailing Address - Phone:207-942-8189
Mailing Address - Fax:
Practice Address - Street 1:109 STATE STREET
Practice Address - Street 2:SUITE 3
Practice Address - City:BANGOR
Practice Address - State:ME
Practice Address - Zip Code:04401-5389
Practice Address - Country:US
Practice Address - Phone:207-942-8189
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-24
Last Update Date:2010-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECC 1684101Y00000X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME223190099Medicaid