Provider Demographics
NPI:1841307600
Name:DORR, REBECCA JEANNE (LCSW)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:JEANNE
Last Name:DORR
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:736 OLD LEWISTON RD
Mailing Address - Street 2:
Mailing Address - City:WINTHROP
Mailing Address - State:ME
Mailing Address - Zip Code:04364-4121
Mailing Address - Country:US
Mailing Address - Phone:207-377-8122
Mailing Address - Fax:207-377-8564
Practice Address - Street 1:736 OLD LEWISTON RD
Practice Address - Street 2:
Practice Address - City:WINTHROP
Practice Address - State:ME
Practice Address - Zip Code:04364-4121
Practice Address - Country:US
Practice Address - Phone:207-377-8122
Practice Address - Fax:207-377-8564
Is Sole Proprietor?:No
Enumeration Date:2006-08-25
Last Update Date:2007-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELC113931041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical