Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MR. MICHAEL JOSEPH PROVENCHER JR., LGPC
Active Sole ProprietorMR. MICHAEL JOSEPH PROVENCHER JR., LGPC is a Mental Health Counselor healthcare provider located in GLYNDON, Maryland. NPI 1811793813 is currently active in the NPPES registry. Verify at CMS.
Mental Health Counselor · GLYNDON, MD
Registration Details
- NPI Number
- 1811793813
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Feb 20, 2025 (1.4579684533453 yrs)
- Last Updated
- Feb 20, 2025
- License
-
LGP15969 (MD)
- Sole Proprietor
- Yes
Practice Information
- Address
-
117 CENTRAL AVEGLYNDON, MD, 210714208Browse MD providers · Browse ZIP 21071
- Phone
- 4432441886
- Primary Specialty
-
Mental Health Counselor
101YM0800X
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.