Healthcare Provider Details

I. General information

NPI: 1063666147
Provider Name (Legal Business Name): LYNNE SWEENEY PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: LYNNE SWEENEY

II. Dates (important events)

Enumeration Date: 11/16/2008
Last Update Date: 07/22/2025
Certification Date: 07/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

70 MAIN ST
PORTER ME
04068-3527
US

IV. Provider business mailing address

70 MAIN ST
PORTER ME
04068-3527
US

V. Phone/Fax

Practice location:
  • Phone: 207-625-8126
  • Fax: 207-625-7820
Mailing address:
  • Phone: 207-625-8126
  • Fax: 207-625-7820

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License NumberRN73983
License Number StateME
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberCNP241618
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: