Healthcare Provider Details

I. General information

NPI: 1639080013
Provider Name (Legal Business Name): MEGAN KEMNA LCSW LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/15/2026
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

113 COLONIAL RD
PORTLAND ME
04102-2043
US

IV. Provider business mailing address

113 COLONIAL RD
PORTLAND ME
04102-2043
US

V. Phone/Fax

Practice location:
  • Phone: 207-749-9536
  • Fax:
Mailing address:
  • Phone: 207-749-9536
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: MS. MEGAN KEMNA
Title or Position: CLINICIAN/OWNER
Credential: LCSW
Phone: 207-749-9536