Provider Demographics
NPI:1225621352
Name:MCMORROW, AUDREY LYNN (LPC)
Entity Type:Individual
Prefix:
First Name:AUDREY
Middle Name:LYNN
Last Name:MCMORROW
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36 JEWELL ST
Mailing Address - Street 2:
Mailing Address - City:BRUNSWICK
Mailing Address - State:ME
Mailing Address - Zip Code:04011-7749
Mailing Address - Country:US
Mailing Address - Phone:401-864-3707
Mailing Address - Fax:
Practice Address - Street 1:36 JEWELL ST
Practice Address - Street 2:
Practice Address - City:BRUNSWICK
Practice Address - State:ME
Practice Address - Zip Code:04011-7749
Practice Address - Country:US
Practice Address - Phone:401-864-3707
Practice Address - Fax:401-864-3707
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-19
Last Update Date:2021-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPC4140101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional