Provider Demographics
NPI:1144312968
Name:DUPONT ANCTIL, KEARA ANNE (LCSW)
Entity type:Individual
Prefix:MRS
First Name:KEARA
Middle Name:ANNE
Last Name:DUPONT ANCTIL
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:KEARA
Other - Middle Name:ANNE
Other - Last Name:SOUTHER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:27 WEBSTER ST
Mailing Address - Street 2:
Mailing Address - City:WESTBROOK
Mailing Address - State:ME
Mailing Address - Zip Code:04092-2432
Mailing Address - Country:US
Mailing Address - Phone:207-318-8735
Mailing Address - Fax:
Practice Address - Street 1:825 MAIN ST STE 4
Practice Address - Street 2:
Practice Address - City:WESTBROOK
Practice Address - State:ME
Practice Address - Zip Code:04092-2873
Practice Address - Country:US
Practice Address - Phone:208-228-3880
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-29
Last Update Date:2015-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELC80421041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical