Provider Demographics
NPI:1891850806
Name:DEROSIER, CATHERINE A (LCPC)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:A
Last Name:DEROSIER
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:KATIE
Other - Middle Name:
Other - Last Name:DEROSIER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCPC
Mailing Address - Street 1:141 N. MAIN ST.
Mailing Address - Street 2:SUITE 201
Mailing Address - City:BREWER
Mailing Address - State:ME
Mailing Address - Zip Code:04412
Mailing Address - Country:US
Mailing Address - Phone:207-356-6692
Mailing Address - Fax:207-989-4778
Practice Address - Street 1:141 N. MAIN ST.
Practice Address - Street 2:SUITE 201
Practice Address - City:BREWER
Practice Address - State:ME
Practice Address - Zip Code:04412
Practice Address - Country:US
Practice Address - Phone:207-356-6692
Practice Address - Fax:207-989-4778
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-27
Last Update Date:2016-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECC2265101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health