Provider Demographics
NPI:1396809539
Name:REICHLINE, ANDREW (LCPC, LMFT)
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:
Last Name:REICHLINE
Suffix:
Gender:M
Credentials:LCPC, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31 TALBOT AVE
Mailing Address - Street 2:
Mailing Address - City:ROCKLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04841-2922
Mailing Address - Country:US
Mailing Address - Phone:207-594-1976
Mailing Address - Fax:207-594-1270
Practice Address - Street 1:31 TALBOT AVE
Practice Address - Street 2:
Practice Address - City:ROCKLAND
Practice Address - State:ME
Practice Address - Zip Code:04841-2922
Practice Address - Country:US
Practice Address - Phone:207-594-1976
Practice Address - Fax:207-594-1270
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-21
Last Update Date:2014-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECC913101YP2500X
MEMF517106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME236620099Medicaid