Provider Demographics
NPI:1942571427
Name:GORCHOFF, MEGHAN KATHLEEN (LCPC)
Entity Type:Individual
Prefix:MRS
First Name:MEGHAN
Middle Name:KATHLEEN
Last Name:GORCHOFF
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 1:13 FOGGS PT. RD.
Mailing Address - Street 2:
Mailing Address - City:FREEPORT
Mailing Address - State:ME
Mailing Address - Zip Code:04032
Mailing Address - Country:US
Mailing Address - Phone:207-844-0804
Mailing Address - Fax:
Practice Address - Street 1:13 FOGGS PT. RD.
Practice Address - Street 2:
Practice Address - City:FREEPORT
Practice Address - State:ME
Practice Address - Zip Code:04032
Practice Address - Country:US
Practice Address - Phone:207-844-0804
Practice Address - Fax:207-799-1350
Is Sole Proprietor?:No
Enumeration Date:2012-01-16
Last Update Date:2018-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECC3896101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health