| Mary C. Hazzard, Lcpc | |
|
331 Cottage Rd South Portland ME 04106-3816 | |
| (207) 767-4600 | |
| Not Available |
| Full Name | Mary C. Hazzard, Lcpc |
|---|---|
| Speciality | Counselor |
| Location | 331 Cottage Rd, South Portland, Maine |
| Authorized Official Name and Position | Mary C Hazzard (OWNER/LCPC) |
| Authorized Official Contact | 2077674600 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mary C. Hazzard, Lcpc Po Box 2777 South Portland ME 04116-2777 Ph: (207) 767-4600 | Mary C. Hazzard, Lcpc 331 Cottage Rd South Portland ME 04106-3816 Ph: (207) 767-4600 |
| NPI Number | 1699588970 |
|---|---|
| Provider Enumeration Date | 01/30/2025 |
| Last Update Date | 01/30/2025 |
| Certification Date | 01/30/2025 |
| Medicare PECOS PAC ID | 6204356389 |
|---|---|
| Medicare Enrollment ID | O20250219002236 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699588970 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
| Provider Name | Mary C Morrison |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1942421268 PECOS PAC ID: 7012437833 Enrollment ID: I20250225000196 |
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