Provider Demographics
NPI:1538449210
Name:WHITTEN, LORIEN COURTENAY SNELLINGS (LCPC)
Entity type:Individual
Prefix:
First Name:LORIEN
Middle Name:COURTENAY SNELLINGS
Last Name:WHITTEN
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:COURTENAY
Other - Middle Name:LORIEN
Other - Last Name:SNELLINGS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCPC
Mailing Address - Street 1:15 MAIN ST
Mailing Address - Street 2:SUITE 221
Mailing Address - City:FREEPORT
Mailing Address - State:ME
Mailing Address - Zip Code:04032-1100
Mailing Address - Country:US
Mailing Address - Phone:207-318-9759
Mailing Address - Fax:
Practice Address - Street 1:15 MAIN ST
Practice Address - Street 2:SUITE 221
Practice Address - City:FREEPORT
Practice Address - State:ME
Practice Address - Zip Code:04032-1100
Practice Address - Country:US
Practice Address - Phone:207-318-9759
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-25
Last Update Date:2014-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECC4208101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional