Provider Demographics
NPI:1861869562
Name:OLANDER, ERIK R (LCPC-C)
Entity type:Individual
Prefix:
First Name:ERIK
Middle Name:R
Last Name:OLANDER
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:PO BOX 600
Mailing Address - Street 2:
Mailing Address - City:SOUTH CASCO
Mailing Address - State:ME
Mailing Address - Zip Code:04077-0600
Mailing Address - Country:US
Mailing Address - Phone:207-632-3031
Mailing Address - Fax:
Practice Address - Street 1:25 MIDDLE ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04101-4869
Practice Address - Country:US
Practice Address - Phone:207-632-3031
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-28
Last Update Date:2015-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEXL4567101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional