Individual
MS. MERRILEE DAHM LARSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCPC
Contact information
Practice address
53 BAXTER BLVD STE 3, PORTLAND, ME 04101-1827
(603) 883-0005
Mailing address
53 BAXTER BLVD STE 3, PORTLAND, ME 04101-1827
(603) 883-0005
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
CCS4150
ME
101YM0800X
Mental Health Counselor
CC984
ME
101YP2500X
Professional Counselor
Primary
CC984
ME
Other
Enumeration date
02/05/2009
Last updated
04/29/2024
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