Healthcare Provider Details

I. General information

NPI: 1801532064
Provider Name (Legal Business Name): MELANIE LYNN DUMAS LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/10/2022
Last Update Date: 10/02/2024
Certification Date: 10/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

474 MAIN ST
SPRINGVALE ME
04083-1409
US

IV. Provider business mailing address

41 POND VIEW DR
LEBANON ME
04027-4237
US

V. Phone/Fax

Practice location:
  • Phone: 207-317-3772
  • Fax:
Mailing address:
  • Phone: 207-205-7541
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLC24065
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: