Provider Demographics
NPI:1851548879
Name:STONE, DOREEN LEE (LMSW-CC)
Entity Type:Individual
Prefix:
First Name:DOREEN
Middle Name:LEE
Last Name:STONE
Suffix:
Gender:F
Credentials:LMSW-CC
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 28
Mailing Address - Street 2:
Mailing Address - City:WEST KENNEBUNK
Mailing Address - State:ME
Mailing Address - Zip Code:04094-0028
Mailing Address - Country:US
Mailing Address - Phone:207-985-3771
Mailing Address - Fax:
Practice Address - Street 1:345 BROWN ST
Practice Address - Street 2:
Practice Address - City:WESTBROOK
Practice Address - State:ME
Practice Address - Zip Code:04092-2947
Practice Address - Country:US
Practice Address - Phone:207-205-1123
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-20
Last Update Date:2008-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEME149243104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker