Mr Michael Joseph Provencher Jr, LGPC - Counselor in Glyndon, MD

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Mr Michael Joseph Provencher Jr, LGPC is a Counselor - Mental Health based in Glyndon, Maryland. Mr Michael Joseph Provencher Jr is licensed to practice in Maryland (license number LGP15969) and his current practice location is 117 Central Ave, Glyndon, Maryland. He can be reached at his office (for appointments etc.) via phone at (443) 244-1886.

NPI number for Mr Michael Joseph Provencher Jr is 1811793813 and his current mailing address is Po Box 3, 117 Central Ave., Glyndon, Maryland. He does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1811793813.

Contact Information

Mr Michael Joseph Provencher Jr, LGPC
117 Central Ave,
Glyndon, MD 21071-4208
(443) 244-1886
Not Available

Map and Direction


Healthcare Provider's Profile

Full NameMr Michael Joseph Provencher Jr
GenderMale
SpecialityCounselor - Mental Health
Location117 Central Ave, Glyndon, Maryland
Accepts Medicare AssignmentsDoes not participate in Medicare Program. He may not accept medicare assignment.
  NPI Data:
  • NPI Number: 1811793813
  • Provider Enumeration Date: 02/20/2025
  • Last Update Date: 02/20/2025

Medical Identifiers

Medical identifiers for Mr Michael Joseph Provencher Jr such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1811793813NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
101YM0800XCounselor - Mental Health LGP15969 (Maryland)Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mr Michael Joseph Provencher Jr is NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Mr Michael Joseph Provencher Jr, LGPC
Po Box 3, 117 Central Ave.,
Glyndon, MD 21071

Ph: (443) 244-1860		Mr Michael Joseph Provencher Jr, LGPC
117 Central Ave,
Glyndon, MD 21071-4208

Ph: (443) 244-1886

Reviews and Comments


Counselor in Glyndon, MD


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