Provider Demographics
NPI:1821167347
Name:KARLSON, DONNA MAE (LCSW ACSW)
Entity Type:Individual
Prefix:MS
First Name:DONNA
Middle Name:MAE
Last Name:KARLSON
Suffix:
Gender:F
Credentials:LCSW ACSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 DEVON ROAD
Mailing Address - Street 2:
Mailing Address - City:BAR HARBOR
Mailing Address - State:ME
Mailing Address - Zip Code:04609
Mailing Address - Country:US
Mailing Address - Phone:207-288-8335
Mailing Address - Fax:
Practice Address - Street 1:8 DEVON ROAD
Practice Address - Street 2:
Practice Address - City:BAR HARBOR
Practice Address - State:ME
Practice Address - Zip Code:04609
Practice Address - Country:US
Practice Address - Phone:207-288-8335
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-07
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELC35201041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME017073OtherGREENSPRING
ME017073OtherANTHEM BCBS
MM8700Medicare ID - Type Unspecified