Provider Demographics
NPI:1891464194
Name:MIDCOAST COUNSELING GROUP, PLLC
Entity type:Organization
Organization Name:MIDCOAST COUNSELING GROUP, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER & THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:LAUREN
Authorized Official - Middle Name:SHEPARD BROOKS
Authorized Official - Last Name:HAMPLE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:207-716-5440
Mailing Address - Street 1:135 MAINE ST.
Mailing Address - Street 2:SUITE A BOX 246
Mailing Address - City:BRUNSWICK
Mailing Address - State:ME
Mailing Address - Zip Code:04011
Mailing Address - Country:US
Mailing Address - Phone:207-716-5440
Mailing Address - Fax:207-618-7408
Practice Address - Street 1:6 FEDERAL ST
Practice Address - Street 2:OFFICE C
Practice Address - City:BRUNSWICK
Practice Address - State:ME
Practice Address - Zip Code:04011
Practice Address - Country:US
Practice Address - Phone:207-716-5440
Practice Address - Fax:207-618-7408
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-09
Last Update Date:2021-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty