Provider Demographics
NPI:1336494715
Name:BAIN, MEGAN MARY (LCSW)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:MARY
Last Name:BAIN
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 1:24 MILES WAY
Mailing Address - Street 2:
Mailing Address - City:DAMARISCOTTA
Mailing Address - State:ME
Mailing Address - Zip Code:04543
Mailing Address - Country:US
Mailing Address - Phone:207-701-4400
Mailing Address - Fax:
Practice Address - Street 1:24 MILES WAY
Practice Address - Street 2:
Practice Address - City:DAMARISCOTTA
Practice Address - State:ME
Practice Address - Zip Code:04543
Practice Address - Country:US
Practice Address - Phone:207-701-4400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-20
Last Update Date:2020-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT89781041C0700X
MELC183341041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical