Provider Demographics
NPI:1588086201
Name:GUAY, LAURIE (LCPC-C)
Entity type:Individual
Prefix:
First Name:LAURIE
Middle Name:
Last Name:GUAY
Suffix:
Gender:F
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 1:180 MAIN ST
Mailing Address - Street 2:SUITE 4
Mailing Address - City:WATERVILLE
Mailing Address - State:ME
Mailing Address - Zip Code:04901-6666
Mailing Address - Country:US
Mailing Address - Phone:207-872-5300
Mailing Address - Fax:
Practice Address - Street 1:180 MAIN ST
Practice Address - Street 2:SUITE 4
Practice Address - City:WATERVILLE
Practice Address - State:ME
Practice Address - Zip Code:04901-6666
Practice Address - Country:US
Practice Address - Phone:207-872-5300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-01-15
Last Update Date:2014-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEXL4179101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional