Provider Demographics
NPI:1952014532
Name:MERRILL, BREEANN (LCPC-C)
Entity type:Individual
Prefix:
First Name:BREEANN
Middle Name:
Last Name:MERRILL
Suffix:
Gender:F
Credentials:LCPC-C
Other - Prefix:
Other - First Name:BREEANN
Other - Middle Name:
Other - Last Name:SAUTTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:33 SPRINGER FARM RD
Mailing Address - Street 2:
Mailing Address - City:SABATTUS
Mailing Address - State:ME
Mailing Address - Zip Code:04280-4747
Mailing Address - Country:US
Mailing Address - Phone:207-402-7991
Mailing Address - Fax:
Practice Address - Street 1:33 SPRINGER FARM RD
Practice Address - Street 2:
Practice Address - City:SABATTUS
Practice Address - State:ME
Practice Address - Zip Code:04280-4747
Practice Address - Country:US
Practice Address - Phone:207-402-7991
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-28
Last Update Date:2024-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEXL6992101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health