Provider Demographics
NPI:1811604945
Name:TRICIA LEDOUX COUNSELING LLC
Entity type:Organization
Organization Name:TRICIA LEDOUX COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:A
Authorized Official - Last Name:LEDOUX
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:207-352-0433
Mailing Address - Street 1:PO BOX 2258
Mailing Address - Street 2:
Mailing Address - City:BIDDEFORD
Mailing Address - State:ME
Mailing Address - Zip Code:04005-8258
Mailing Address - Country:US
Mailing Address - Phone:207-352-0433
Mailing Address - Fax:
Practice Address - Street 1:1 HIGH ST STE 7
Practice Address - Street 2:
Practice Address - City:KENNEBUNK
Practice Address - State:ME
Practice Address - Zip Code:04043-7148
Practice Address - Country:US
Practice Address - Phone:207-352-0433
Practice Address - Fax:877-366-4620
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-28
Last Update Date:2024-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME1700423837Medicaid