Healthcare Provider Details

I. General information

NPI: 1417881699
Provider Name (Legal Business Name): CAREY MARIE DONEGAN LMSW-CC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/11/2026
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

66 STONE ST
AUGUSTA ME
04330-5227
US

IV. Provider business mailing address

277 SHUSTA RD
MADISON ME
04950-4103
US

V. Phone/Fax

Practice location:
  • Phone: 207-604-4159
  • Fax:
Mailing address:
  • Phone: 207-604-4159
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberMC25198
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: