Provider Demographics
NPI:1427538693
Name:HODGDON-MCBURNEY, TAYLOR LYN (LMFT)
Entity Type:Individual
Prefix:
First Name:TAYLOR
Middle Name:LYN
Last Name:HODGDON-MCBURNEY
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1053 POND RD
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:ME
Mailing Address - Zip Code:04352-3140
Mailing Address - Country:US
Mailing Address - Phone:207-240-5770
Mailing Address - Fax:
Practice Address - Street 1:67 EUSTIS PKWY
Practice Address - Street 2:
Practice Address - City:WATERVILLE
Practice Address - State:ME
Practice Address - Zip Code:04901-5173
Practice Address - Country:US
Practice Address - Phone:207-873-2136
Practice Address - Fax:207-660-4529
Is Sole Proprietor?:No
Enumeration Date:2018-08-17
Last Update Date:2021-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEMF6242106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist