Provider Demographics
NPI:1083592752
Name:DENNISON, REBECCA (LMSW-C)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:DENNISON
Suffix:
Gender:X
Credentials:LMSW-C
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 6
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:ME
Mailing Address - Zip Code:04938-0006
Mailing Address - Country:US
Mailing Address - Phone:207-491-3132
Mailing Address - Fax:
Practice Address - Street 1:115 MT BLUE CIR
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:ME
Practice Address - Zip Code:04938-6276
Practice Address - Country:US
Practice Address - Phone:207-491-3132
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-22
Last Update Date:2025-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEMC25145104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker