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NPI Code Detail

MEDICARE: LYNNE UNGER LCSW

MEDICARE: LYNNE UNGER LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social WorkerLC6221ME

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
118285OTHERMEBLUE CROSS BLUE SHIELD
2PO30913OTHERMETRICARE

General Provider Information

NPI Number : 1669418430
Entity Type Code : Individual
Provider Name (Legal Business Name) : LYNNE UNGER LCSW
Provider Business Mailing Address
First Line : 345 COTTAGE RD
Second Line :
City : SOUTH PORTLAND
State : ME
Zip : 04106-3919
Country : US
Telephone Number : 207-799-9198
Fax Number : 207-799-5151
Provider Business Practice Location Address
First Line : 345 COTTAGE RD
Second Line :
City : SOUTH PORTLAND
State : ME
Zip : 04106-3919
Country : US
Telephone Number : 207-799-9198
Fax Number : 207-799-5151
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/21/2006
Last Update Date : 06/04/2019

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