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

Mr. Michael Joseph Provencher Jr., LGPC

Individual provider Mental Health Counselor · NPI 1811793813

Mr. Michael Joseph Provencher Jr., LGPC is a Mental Health Counselor in Glyndon, Maryland. Practices as a sole proprietor. Licensed in Maryland.

Licensed in
MD
In the registry since
2025

Practice location Address checks out

117 Central Ave
Glyndon, MD 21071-4208
Phone: (443) 244-1886
Show map & directions

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

Specialties & licences

Mental Health Counselor (primary) Taxonomy 101YM0800X · Licence LGP15969 (MD)

Record details

NPI number1811793813
Entity typeIndividual (Type 1)
GenderMale
Credentials LGPC
Sole proprietorYes
NPI enumeratedFebruary 20, 2025
Last updated in NPPESFebruary 20, 2025
Certification dateFebruary 20, 2025