Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Lacey Bourgoin, SLP-A

Individual provider Mental Health Counselor · NPI 1528467792

Lacey Bourgoin, SLP-A is a Mental Health Counselor in Randolph, Maine. Licensed in Pennsylvania. Registered with an NPI since 2014.

Licensed in
PA
In the registry since
2014
Specialties on file
2

Practice location Address checks out

17 School St
Randolph, ME 04346-5143
Phone: (207) 588-2699
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Speech-Language Assistant (primary) Taxonomy 2355S0801X
Mental Health Counselor Taxonomy 101YM0800X · Licence BH001153 (PA)

Record details

NPI number1528467792
Entity typeIndividual (Type 1)
GenderFemale
Credentials SLP-A
Sole proprietorNo
NPI enumeratedAugust 14, 2014
Last updated in NPPESAugust 21, 2024
Certification dateAugust 21, 2024
Mailing address17 School St, Randolph, ME 04346-5143

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