Provider Demographics
NPI:1689055485
Name:HARRIGAN, THERESSA MARIA (LCPC, LADC)
Entity type:Individual
Prefix:
First Name:THERESSA
Middle Name:MARIA
Last Name:HARRIGAN
Suffix:
Gender:F
Credentials:LCPC, LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 176
Mailing Address - Street 2:
Mailing Address - City:PARSONSFIELD
Mailing Address - State:ME
Mailing Address - Zip Code:04047-0176
Mailing Address - Country:US
Mailing Address - Phone:207-305-0439
Mailing Address - Fax:
Practice Address - Street 1:19 RIVER RD
Practice Address - Street 2:
Practice Address - City:HIRAM
Practice Address - State:ME
Practice Address - Zip Code:04041-3516
Practice Address - Country:US
Practice Address - Phone:207-305-0939
Practice Address - Fax:207-767-0995
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-17
Last Update Date:2020-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEXL4544101Y00000X
MECC4888101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME1164484093Medicaid