Individual provider · Type 1 NPI
Dolphin Moon Avery-Grubel, LCPC-C
Professional Counselor · South Portland, ME
NPI number
1801628664
Active
Practice location
105 Boothby Ave
South Portland, ME 04106-4631
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Professional Counselor Primary | 101YP2500X | XL7648 (ME) |
Professional Counselor: Definition to come...
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About NPI 1801628664
Dolphin Moon Avery-Grubel, LCPC-C's National Provider Identifier is 1801628664, issued on Aug 19, 2024. The primary taxonomy on file is Professional Counselor (101YP2500X), and the practice location is in South Portland, ME. The record was last updated on Aug 19, 2026.