Provider Demographics
NPI:1902277858
Name:MEEHAN, LYNN
Entity Type:Individual
Prefix:
First Name:LYNN
Middle Name:
Last Name:MEEHAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13 NH ROUTE 16A STE 3
Mailing Address - Street 2:
Mailing Address - City:INTERVALE
Mailing Address - State:NH
Mailing Address - Zip Code:03845-6300
Mailing Address - Country:US
Mailing Address - Phone:603-662-2450
Mailing Address - Fax:207-935-3632
Practice Address - Street 1:253 BRIDGTON RD
Practice Address - Street 2:
Practice Address - City:FRYEBURG
Practice Address - State:ME
Practice Address - Zip Code:04037-1438
Practice Address - Country:US
Practice Address - Phone:207-935-3383
Practice Address - Fax:207-935-3632
Is Sole Proprietor?:No
Enumeration Date:2015-10-16
Last Update Date:2022-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELC15711104100000X
NH19191041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker