Provider Demographics
NPI:1154592822
Name:KELLEY, LYNN F (LCSW)
Entity type:Individual
Prefix:
First Name:LYNN
Middle Name:F
Last Name:KELLEY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:LYNN
Other - Middle Name:C
Other - Last Name:FRAIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1333 UNION RD
Mailing Address - Street 2:
Mailing Address - City:APPLETON
Mailing Address - State:ME
Mailing Address - Zip Code:04862-6607
Mailing Address - Country:US
Mailing Address - Phone:207-785-2182
Mailing Address - Fax:
Practice Address - Street 1:1333 UNION RD
Practice Address - Street 2:
Practice Address - City:APPLETON
Practice Address - State:ME
Practice Address - Zip Code:04862-6607
Practice Address - Country:US
Practice Address - Phone:207-785-2182
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-20
Last Update Date:2008-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME#LC4620101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health