Healthcare Provider Details

I. General information

NPI: 1275733917
Provider Name (Legal Business Name): ERIN RHEA GAGNON LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/20/2007
Last Update Date: 08/18/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

408 GRAY RD
WINDHAM ME
04062-4290
US

IV. Provider business mailing address

115 FALMOUTH RD
WINDHAM ME
04062-4536
US

V. Phone/Fax

Practice location:
  • Phone: 207-892-1820
  • Fax:
Mailing address:
  • Phone: 207-632-3008
  • Fax: 207-874-8150

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLC13337
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: