Provider Demographics
NPI:1104011220
Name:WINN, LEA ELAINE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:LEA
Middle Name:ELAINE
Last Name:WINN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:LEA
Other - Middle Name:ELAINE
Other - Last Name:ANDERSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LICSW
Mailing Address - Street 1:20 KATHERINE ST
Mailing Address - Street 2:33
Mailing Address - City:BRUNSWICK
Mailing Address - State:ME
Mailing Address - Zip Code:04011-1683
Mailing Address - Country:US
Mailing Address - Phone:207-406-1650
Mailing Address - Fax:
Practice Address - Street 1:1 LINCOLN ST
Practice Address - Street 2:SUITE 8
Practice Address - City:BATH
Practice Address - State:ME
Practice Address - Zip Code:04530-2100
Practice Address - Country:US
Practice Address - Phone:207-406-1650
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-11
Last Update Date:2011-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELC61171041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical