Healthcare Provider Details

I. General information

NPI: 1427602283
Provider Name (Legal Business Name): MEAGHAN L. MARTIN LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/30/2019
Last Update Date: 05/05/2025
Certification Date: 05/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

180 MAIN ST
BIDDEFORD ME
04005-2410
US

IV. Provider business mailing address

PO BOX 15
STANDISH ME
04084-0015
US

V. Phone/Fax

Practice location:
  • Phone: 207-571-3008
  • Fax: 207-571-3263
Mailing address:
  • Phone: 207-613-6416
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberMC18064
License Number StateME

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: