Provider Demographics
NPI:1184065914
Name:ARCHIBALD, APRIL (LADC)
Entity type:Individual
Prefix:
First Name:APRIL
Middle Name:
Last Name:ARCHIBALD
Suffix:
Gender:F
Credentials:LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:43 COLUMBIA ST
Mailing Address - Street 2:SUITE 12
Mailing Address - City:BANGOR
Mailing Address - State:ME
Mailing Address - Zip Code:04401-6346
Mailing Address - Country:US
Mailing Address - Phone:207-573-4126
Mailing Address - Fax:207-573-4126
Practice Address - Street 1:43 COLUMBIA ST
Practice Address - Street 2:SUITE 12
Practice Address - City:BANGOR
Practice Address - State:ME
Practice Address - Zip Code:04401-6346
Practice Address - Country:US
Practice Address - Phone:207-573-4126
Practice Address - Fax:207-573-4126
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-09
Last Update Date:2016-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELC5946101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)