Healthcare Provider Details

I. General information

NPI: 1275459414
Provider Name (Legal Business Name): MORGAN MULLEN LMSW-CC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/24/2026
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

67 EUSTIS PKWY
WATERVILLE ME
04901-5173
US

IV. Provider business mailing address

244 WASHINGTON ST
OAKLAND ME
04963-5250
US

V. Phone/Fax

Practice location:
  • Phone: 207-212-6716
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberMC26139
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: