Provider Demographics
NPI:1548295918
Name:DUMAS, GREGORY P (LCSW)
Entity type:Individual
Prefix:MR
First Name:GREGORY
Middle Name:P
Last Name:DUMAS
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 WATER ST
Mailing Address - Street 2:SUITE 4 SACO BAY COUNSELING
Mailing Address - City:SACO
Mailing Address - State:ME
Mailing Address - Zip Code:04072-2724
Mailing Address - Country:US
Mailing Address - Phone:207-284-9667
Mailing Address - Fax:207-284-9667
Practice Address - Street 1:23 WATER ST
Practice Address - Street 2:SUITE 4 SACO BAY COUNSELING
Practice Address - City:SACO
Practice Address - State:ME
Practice Address - Zip Code:04072-2724
Practice Address - Country:US
Practice Address - Phone:207-284-9667
Practice Address - Fax:207-284-9667
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELC6231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
003837OtherANTHEM
003837OtherANTHEM