Basic Information
| Provider Information | |||||||||
| NPI: | 1689055485 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HARRIGAN | ||||||||
| FirstName: | THERESSA | ||||||||
| MiddleName: | MARIA | ||||||||
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| Credential: | LCPC, LADC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 176 | ||||||||
| Address2: | |||||||||
| City: | PARSONSFIELD | ||||||||
| State: | ME | ||||||||
| PostalCode: | 040470176 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2073050439 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 19 RIVER RD | ||||||||
| Address2: | |||||||||
| City: | HIRAM | ||||||||
| State: | ME | ||||||||
| PostalCode: | 040413516 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2073050939 | ||||||||
| FaxNumber: | 2077670995 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/17/2015 | ||||||||
| LastUpdateDate: | 08/13/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 08/13/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101Y00000X | XL4544 | ME | N | Behavioral Health & Social Service Providers | Counselor | 101YM0800X | CC4888 | ME | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.