Provider Demographics
NPI:1184958589
Name:RANGER, MARTHA MARY S (LCPC)
Entity type:Individual
Prefix:
First Name:MARTHA MARY
Middle Name:S
Last Name:RANGER
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:P.O. BOX 422
Mailing Address - Street 2:ACADIA HOSPITAL CORP.
Mailing Address - City:BANGOR
Mailing Address - State:ME
Mailing Address - Zip Code:04402-0422
Mailing Address - Country:US
Mailing Address - Phone:207-973-6297
Mailing Address - Fax:207-973-6985
Practice Address - Street 1:268 STILLWATER AVENUE
Practice Address - Street 2:ACADIA HOSPITAL CORP.
Practice Address - City:BANGOR
Practice Address - State:ME
Practice Address - Zip Code:04401-0000
Practice Address - Country:US
Practice Address - Phone:207-973-6297
Practice Address - Fax:207-973-6985
Is Sole Proprietor?:No
Enumeration Date:2009-10-01
Last Update Date:2011-09-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MECC3761101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional