Provider Demographics
NPI:1578116174
Name:WRIGHT, DORINE (LMSW/CC)
Entity type:Individual
Prefix:
First Name:DORINE
Middle Name:
Last Name:WRIGHT
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 1:14 ELM ST
Mailing Address - Street 2:
Mailing Address - City:JAY
Mailing Address - State:ME
Mailing Address - Zip Code:04239-1628
Mailing Address - Country:US
Mailing Address - Phone:207-735-4516
Mailing Address - Fax:
Practice Address - Street 1:284 MAIN ST STE 150
Practice Address - Street 2:
Practice Address - City:WILTON
Practice Address - State:ME
Practice Address - Zip Code:04294-3056
Practice Address - Country:US
Practice Address - Phone:207-645-2913
Practice Address - Fax:207-645-2983
Is Sole Proprietor?:No
Enumeration Date:2019-07-23
Last Update Date:2024-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEMC18095104100000X
MELC192221041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker