Provider Demographics
NPI:1578216412
Name:DONAHUE, TERENCE (LMSW-CC, CADC)
Entity Type:Individual
Prefix:
First Name:TERENCE
Middle Name:
Last Name:DONAHUE
Suffix:
Gender:M
Credentials:LMSW-CC, CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 FLYING POINT RD
Mailing Address - Street 2:
Mailing Address - City:FREEPORT
Mailing Address - State:ME
Mailing Address - Zip Code:04032-6436
Mailing Address - Country:US
Mailing Address - Phone:207-751-9454
Mailing Address - Fax:
Practice Address - Street 1:35 FLYING POINT RD
Practice Address - Street 2:
Practice Address - City:FREEPORT
Practice Address - State:ME
Practice Address - Zip Code:04032-6436
Practice Address - Country:US
Practice Address - Phone:207-751-9454
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-01
Last Update Date:2022-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECAC4966101YA0400X
MEMC200081041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)