Provider Demographics
NPI:1285228593
Name:DUGAS, KRISTINA A (LMSW-CC)
Entity Type:Individual
Prefix:
First Name:KRISTINA
Middle Name:A
Last Name:DUGAS
Suffix:
Gender:F
Credentials:LMSW-CC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 BLOOMFIELD ST
Mailing Address - Street 2:
Mailing Address - City:SKOWHEGAN
Mailing Address - State:ME
Mailing Address - Zip Code:04976-1107
Mailing Address - Country:US
Mailing Address - Phone:207-313-2477
Mailing Address - Fax:
Practice Address - Street 1:30 LEAVITT ST
Practice Address - Street 2:
Practice Address - City:SKOWHEGAN
Practice Address - State:ME
Practice Address - Zip Code:04976-1843
Practice Address - Country:US
Practice Address - Phone:207-542-4301
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-26
Last Update Date:2021-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEMC19757104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker