Provider Demographics
NPI:1730378472
Name:DEBORAH A DANA LCSW LLC
Entity type:Organization
Organization Name:DEBORAH A DANA LCSW LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:A
Authorized Official - Last Name:DANA
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:207-571-3095
Mailing Address - Street 1:PO BOX 7125
Mailing Address - Street 2:
Mailing Address - City:CAPE PORPOISE
Mailing Address - State:ME
Mailing Address - Zip Code:04014-7125
Mailing Address - Country:US
Mailing Address - Phone:207-831-9777
Mailing Address - Fax:207-571-3097
Practice Address - Street 1:342 MAIN ST
Practice Address - Street 2:
Practice Address - City:SACO
Practice Address - State:ME
Practice Address - Zip Code:04072-1516
Practice Address - Country:US
Practice Address - Phone:207-831-9777
Practice Address - Fax:207-571-3097
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-18
Last Update Date:2008-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELC105341041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
0002018Medicare PIN