Provider Demographics
NPI:1033204177
Name:BENSON, LYNN (PHD, LCPC)
Entity Type:Individual
Prefix:DR
First Name:LYNN
Middle Name:
Last Name:BENSON
Suffix:
Gender:F
Credentials:PHD, LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 213
Mailing Address - Street 2:
Mailing Address - City:BAR HARBOR
Mailing Address - State:ME
Mailing Address - Zip Code:04609-0213
Mailing Address - Country:US
Mailing Address - Phone:207-667-1988
Mailing Address - Fax:207-667-1993
Practice Address - Street 1:10 HANCOCK ST
Practice Address - Street 2:
Practice Address - City:ELLSWORTH
Practice Address - State:ME
Practice Address - Zip Code:04605-2015
Practice Address - Country:US
Practice Address - Phone:207-667-1988
Practice Address - Fax:207-667-1993
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2009-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECC957101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
MECC957OtherMAINE LICENSE