Provider Demographics
NPI:1750315750
Name:ACORN, DONALD (LCSW)
Entity Type:Individual
Prefix:
First Name:DONALD
Middle Name:
Last Name:ACORN
Suffix:
Gender:M
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:PO BOX 72
Mailing Address - Street 2:
Mailing Address - City:VIENNA
Mailing Address - State:ME
Mailing Address - Zip Code:04360-0072
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:347 DEPOT ST
Practice Address - Street 2:
Practice Address - City:WILTON
Practice Address - State:ME
Practice Address - Zip Code:04294-6655
Practice Address - Country:US
Practice Address - Phone:207-294-4657
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELC77731041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical