Provider Demographics
NPI:1083127617
Name:MCINTIRE, DARA K (LCSW)
Entity Type:Individual
Prefix:
First Name:DARA
Middle Name:K
Last Name:MCINTIRE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:DARA
Other - Middle Name:
Other - Last Name:KIDDER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:163 FOREST AVE
Mailing Address - Street 2:
Mailing Address - City:ORONO
Mailing Address - State:ME
Mailing Address - Zip Code:04473-4723
Mailing Address - Country:US
Mailing Address - Phone:207-356-1622
Mailing Address - Fax:
Practice Address - Street 1:163 FOREST AVE
Practice Address - Street 2:
Practice Address - City:ORONO
Practice Address - State:ME
Practice Address - Zip Code:04473
Practice Address - Country:US
Practice Address - Phone:207-356-1622
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-06
Last Update Date:2024-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEMC150871041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical