Basic Information
| Provider Information | |||||||||
| NPI: | 1174852206 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LAPOINTE | ||||||||
| FirstName: | CHRISTINE | ||||||||
| MiddleName: | C | ||||||||
| NamePrefix: | MRS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | LMSW-CC | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | GAGNON | ||||||||
| OtherFirstName: | CHRISTINE | ||||||||
| OtherMiddleName: | |||||||||
| OtherNamePrefix: | |||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | |||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 110 POPLAR ST | ||||||||
| Address2: | |||||||||
| City: | VAN BUREN | ||||||||
| State: | ME | ||||||||
| PostalCode: | 047851153 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2078683354 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 43 HATCH DR STE 310 | ||||||||
| Address2: | |||||||||
| City: | CARIBOU | ||||||||
| State: | ME | ||||||||
| PostalCode: | 047362039 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2074933361 | ||||||||
| FaxNumber: | 2074924889 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/20/2009 | ||||||||
| LastUpdateDate: | 04/23/2021 | ||||||||
| NPIDeactivationReasonCode: | |||||||||
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| NPIReactivationDate: | |||||||||
| ProviderGenderCode: | F | ||||||||
| AuthorizedOfficialLastName: | |||||||||
| AuthorizedOfficialFirstName: | |||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | |||||||||
| AuthorizedOfficialTelephone: | |||||||||
| IsSoleProprietor: | Y | ||||||||
| IsOrganizationSubpart: | |||||||||
| ParentOrganizationLBN: | |||||||||
| AuthorizedOfficialNamePrefix: | |||||||||
| AuthorizedOfficialNameSuffix: | |||||||||
| AuthorizedOfficialCredential: | |||||||||
| NPICertificationDate: | 04/23/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 376G00000X | N | Nursing Service Related Providers | Nursing Home Administrator | 101Y00000X | MC19783 | ME | Y | Behavioral Health & Social Service Providers | Counselor |
ID Information
| ID | Type | State | Issuer | Description | 201590000 | 05 | ME | MEDICAID |