Provider Demographics
NPI:1134344591
Name:HUNTER, JOHN WILLIAM (LCPC, LADC, CCS)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:WILLIAM
Last Name:HUNTER
Suffix:
Gender:M
Credentials:LCPC, LADC, CCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1472 STILLWATER AVE.
Mailing Address - Street 2:
Mailing Address - City:BANGOR
Mailing Address - State:ME
Mailing Address - Zip Code:04401
Mailing Address - Country:US
Mailing Address - Phone:207-990-0121
Mailing Address - Fax:
Practice Address - Street 1:42 CEDAR STREET
Practice Address - Street 2:
Practice Address - City:BANGOR
Practice Address - State:ME
Practice Address - Zip Code:04401
Practice Address - Country:US
Practice Address - Phone:207-947-0366
Practice Address - Fax:207-942-4350
Is Sole Proprietor?:No
Enumeration Date:2007-04-13
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECC1715101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional