Healthcare Provider Details

I. General information

NPI: 1518735901
Provider Name (Legal Business Name): BRYN MCQUEEN DAWSON LCPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/14/2023
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

37 MILL ST STE 9
BRUNSWICK ME
04011-1914
US

IV. Provider business mailing address

37 MILL ST STE 9
BRUNSWICK ME
04011-1914
US

V. Phone/Fax

Practice location:
  • Phone: 207-352-1668
  • Fax:
Mailing address:
  • Phone: 207-352-1668
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberCC8478
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: