Provider Demographics
NPI:1730527813
Name:DALESSANDRI, CHAD (LCPC-C)
Entity type:Individual
Prefix:
First Name:CHAD
Middle Name:
Last Name:DALESSANDRI
Suffix:
Gender:M
Credentials:LCPC-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:686 RIVER RD
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:ME
Mailing Address - Zip Code:04027-3934
Mailing Address - Country:US
Mailing Address - Phone:603-534-0728
Mailing Address - Fax:
Practice Address - Street 1:435 US ROUTE 1
Practice Address - Street 2:
Practice Address - City:KITTERY
Practice Address - State:ME
Practice Address - Zip Code:03904-2510
Practice Address - Country:US
Practice Address - Phone:603-534-0728
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-11
Last Update Date:2013-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEXL4069101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health