Provider Demographics
NPI:1356999700
Name:KEMNA, MEGAN LYN (LMSW-CC)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:LYN
Last Name:KEMNA
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 1:110 MAIN ST STE 1306D
Mailing Address - Street 2:
Mailing Address - City:SACO
Mailing Address - State:ME
Mailing Address - Zip Code:04072-3516
Mailing Address - Country:US
Mailing Address - Phone:207-749-9536
Mailing Address - Fax:
Practice Address - Street 1:110 MAIN ST STE 1306D
Practice Address - Street 2:
Practice Address - City:SACO
Practice Address - State:ME
Practice Address - Zip Code:04072-3516
Practice Address - Country:US
Practice Address - Phone:207-749-9536
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-29
Last Update Date:2019-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEMC18107104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker