Provider Demographics
NPI:1992285001
Name:DUMARS, DAL MARQUE (LCPC)
Entity type:Individual
Prefix:
First Name:DAL
Middle Name:MARQUE
Last Name:DUMARS
Suffix:
Gender:M
Credentials:LCPC
Other - Prefix:
Other - First Name:MARK
Other - Middle Name:
Other - Last Name:DUMARS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MA, LCPC, ACS
Mailing Address - Street 1:11 BAXTER BLVD
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04101-1801
Mailing Address - Country:US
Mailing Address - Phone:603-490-6594
Mailing Address - Fax:
Practice Address - Street 1:11 BAXTER BLVD
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04101-1801
Practice Address - Country:US
Practice Address - Phone:603-490-6594
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-17
Last Update Date:2024-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECC7430101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional