Provider Demographics
NPI:1487769758
Name:GIGUERE, JOHN LUCIEN (LCPC/LADC)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:LUCIEN
Last Name:GIGUERE
Suffix:
Gender:M
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 1:30 HIGH ST
Mailing Address - Street 2:
Mailing Address - City:SKOWHEGAN
Mailing Address - State:ME
Mailing Address - Zip Code:04976-1828
Mailing Address - Country:US
Mailing Address - Phone:207-474-8368
Mailing Address - Fax:207-474-7794
Practice Address - Street 1:30 HIGH ST
Practice Address - Street 2:
Practice Address - City:SKOWHEGAN
Practice Address - State:ME
Practice Address - Zip Code:04976-1828
Practice Address - Country:US
Practice Address - Phone:207-474-8368
Practice Address - Fax:207-474-7794
Is Sole Proprietor?:No
Enumeration Date:2006-08-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELC907101YA0400X
MECC1557101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional