Provider Demographics
NPI:1437463270
Name:DUFFY, MARIA LYNNE (LCPC)
Entity Type:Individual
Prefix:MS
First Name:MARIA
Middle Name:LYNNE
Last Name:DUFFY
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 TREMONT ST APT 2
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04103-3152
Mailing Address - Country:US
Mailing Address - Phone:207-572-0114
Mailing Address - Fax:
Practice Address - Street 1:12 TREMONT ST #2
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04103-3152
Practice Address - Country:US
Practice Address - Phone:207-572-0114
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-04
Last Update Date:2020-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECC4721101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional