Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MR. LEE TODD LACKS, LCPC-C, MT-BC
Active Sole ProprietorMR. LEE TODD LACKS, LCPC-C, MT-BC is a Community/Behavioral Health healthcare provider located in SOUTH PORTLAND, Maine. NPI 1285918383 is currently active in the NPPES registry. Verify at CMS.
Community/Behavioral Health · SOUTH PORTLAND, ME
Registration Details
- NPI Number
- 1285918383
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Oct 6, 2011 (14.811232499329 yrs)
- Last Updated
- Oct 6, 2011
- Licenses
-
XL3782 (ME)XL3782 (ME)
- Sole Proprietor
- Yes
Practice Information
- Address
-
9 LEMONT AVESOUTH PORTLAND, ME, 041065717Browse ME providers · Browse ZIP 04106
- Phone
- 2072106045
- Primary Specialty
-
Community/Behavioral Health
251S00000X
- Additional Specialty
- Community/Behavioral Health
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.