Provider Demographics
NPI:1730514704
Name:DUMAIS, VICTOR (LCPC, LADC, CCS)
Entity type:Individual
Prefix:
First Name:VICTOR
Middle Name:
Last Name:DUMAIS
Suffix:
Gender:M
Credentials:LCPC, LADC, CCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 BROWN ST
Mailing Address - Street 2:
Mailing Address - City:LEWISTON
Mailing Address - State:ME
Mailing Address - Zip Code:04240-5714
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:22 BROWN ST
Practice Address - Street 2:
Practice Address - City:LEWISTON
Practice Address - State:ME
Practice Address - Zip Code:04240-5714
Practice Address - Country:US
Practice Address - Phone:207-514-4866
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-10
Last Update Date:2024-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAM18684OtherBLUE CROSS BLUE SHEILD
MA22220002001OtherBLUE CROSS
MA1306421Medicaid
MA1308785Medicaid
MA22220002001OtherBLUE CROSS