Provider Demographics
NPI:1801096706
Name:SPRAGUE, ROBIN K (LCPC)
Entity type:Individual
Prefix:MS
First Name:ROBIN
Middle Name:K
Last Name:SPRAGUE
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:96 HARLOW ST
Mailing Address - Street 2:SUITE 375
Mailing Address - City:BANGOR
Mailing Address - State:ME
Mailing Address - Zip Code:04401-4925
Mailing Address - Country:US
Mailing Address - Phone:207-942-3042
Mailing Address - Fax:
Practice Address - Street 1:96 HARLOW ST
Practice Address - Street 2:SUITE 375
Practice Address - City:BANGOR
Practice Address - State:ME
Practice Address - Zip Code:04401-4925
Practice Address - Country:US
Practice Address - Phone:207-942-3042
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-19
Last Update Date:2007-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECC735101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional