Provider Demographics
NPI:1134671464
Name:PONTBRIAND, ERIN (LCPC, CADC, PMH-C)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:
Last Name:PONTBRIAND
Suffix:
Gender:F
Credentials:LCPC, CADC, PMH-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 YORK ST UNIT 201H
Mailing Address - Street 2:
Mailing Address - City:BIDDEFORD
Mailing Address - State:ME
Mailing Address - Zip Code:04005-5534
Mailing Address - Country:US
Mailing Address - Phone:207-518-8565
Mailing Address - Fax:877-366-4620
Practice Address - Street 1:15 YORK ST UNIT 201H
Practice Address - Street 2:
Practice Address - City:BIDDEFORD
Practice Address - State:ME
Practice Address - Zip Code:04005-5534
Practice Address - Country:US
Practice Address - Phone:207-518-8565
Practice Address - Fax:877-366-4620
Is Sole Proprietor?:No
Enumeration Date:2016-11-03
Last Update Date:2021-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECC5910101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health