Healthcare Provider Details

I. General information

NPI: 1578065744
Provider Name (Legal Business Name): ASHLEIGH EDEN DUNN LMSW-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/05/2018
Last Update Date: 06/16/2025
Certification Date: 06/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

67 EUSTIS PKWY
WATERVILLE ME
04901-5173
US

IV. Provider business mailing address

67 EUSTIS PKWY
WATERVILLE ME
04901-5173
US

V. Phone/Fax

Practice location:
  • Phone: 888-322-2136
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberMC24812
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: