Provider Demographics
NPI:1487060919
Name:KANE, COURTNEY A (LCPC, LADC)
Entity type:Individual
Prefix:
First Name:COURTNEY
Middle Name:A
Last Name:KANE
Suffix:
Gender:F
Credentials:LCPC, LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:98 MAINE ST STE 5
Mailing Address - Street 2:
Mailing Address - City:BRUNSWICK
Mailing Address - State:ME
Mailing Address - Zip Code:04011-2031
Mailing Address - Country:US
Mailing Address - Phone:207-522-5066
Mailing Address - Fax:
Practice Address - Street 1:98 MAINE ST
Practice Address - Street 2:THE LINCOLN BUILDING
Practice Address - City:BRUNSWICK
Practice Address - State:ME
Practice Address - Zip Code:04011-2031
Practice Address - Country:US
Practice Address - Phone:207-522-5066
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-03
Last Update Date:2021-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELC5971101YA0400X
MECC4700101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)