Provider Demographics
NPI:1245072412
Name:HILLEGASS, DALE (LCPC-C)
Entity type:Individual
Prefix:
First Name:DALE
Middle Name:
Last Name:HILLEGASS
Suffix:
Gender:M
Credentials:LCPC-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:147 ACADEMY ST
Mailing Address - Street 2:
Mailing Address - City:PRESQUE ISLE
Mailing Address - State:ME
Mailing Address - Zip Code:04769-3101
Mailing Address - Country:US
Mailing Address - Phone:207-551-9899
Mailing Address - Fax:207-764-6077
Practice Address - Street 1:147 ACADEMY ST
Practice Address - Street 2:
Practice Address - City:PRESQUE ISLE
Practice Address - State:ME
Practice Address - Zip Code:04769-3101
Practice Address - Country:US
Practice Address - Phone:207-551-9899
Practice Address - Fax:207-764-6077
Is Sole Proprietor?:No
Enumeration Date:2024-06-10
Last Update Date:2024-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEXL7504101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health