Provider Demographics
NPI:1043272578
Name:HEGGIE, DOROTHY (LCSW)
Entity Type:Individual
Prefix:
First Name:DOROTHY
Middle Name:
Last Name:HEGGIE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1079 HIGH ST
Mailing Address - Street 2:
Mailing Address - City:BATH
Mailing Address - State:ME
Mailing Address - Zip Code:04530-2240
Mailing Address - Country:US
Mailing Address - Phone:207-294-4657
Mailing Address - Fax:
Practice Address - Street 1:650 MAIN ST
Practice Address - Street 2:STE 103
Practice Address - City:SOUTH PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04106-5448
Practice Address - Country:US
Practice Address - Phone:207-409-9523
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-03
Last Update Date:2008-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELC56151041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME250450099OtherMAINECARE
ME250450099OtherMAINECARE