Provider Demographics
NPI:1154649713
Name:BANN, DONNA LYNN (LCPC)
Entity type:Individual
Prefix:MS
First Name:DONNA
Middle Name:LYNN
Last Name:BANN
Suffix:
Gender:
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 HOVEY LN
Mailing Address - Street 2:
Mailing Address - City:BRUNSWICK
Mailing Address - State:ME
Mailing Address - Zip Code:04011-7840
Mailing Address - Country:US
Mailing Address - Phone:207-504-4442
Mailing Address - Fax:207-708-8283
Practice Address - Street 1:9 HOVEY LN
Practice Address - Street 2:
Practice Address - City:BRUNSWICK
Practice Address - State:ME
Practice Address - Zip Code:04011-7840
Practice Address - Country:US
Practice Address - Phone:207-208-9511
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-06
Last Update Date:2025-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECC4158101YM0800X
MER-DMT-1397225600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225600000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDance Therapist
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health