Provider Demographics
NPI:1053417436
Name:CORRIGAN, ONALEE H (LCSW)
Entity type:Individual
Prefix:
First Name:ONALEE
Middle Name:H
Last Name:CORRIGAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:ONALEE
Other - Middle Name:H
Other - Last Name:JOHNSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:78 ATLANTIC PLACE
Mailing Address - Street 2:
Mailing Address - City:SOUTH PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04106-2316
Mailing Address - Country:US
Mailing Address - Phone:207-661-6654
Mailing Address - Fax:207-842-7773
Practice Address - Street 1:66 BARIBEAU DR
Practice Address - Street 2:
Practice Address - City:BRUNSWICK
Practice Address - State:ME
Practice Address - Zip Code:04011-3230
Practice Address - Country:US
Practice Address - Phone:207-373-9466
Practice Address - Fax:207-373-9494
Is Sole Proprietor?:No
Enumeration Date:2006-09-15
Last Update Date:2016-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELC71041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME262480099Medicaid
MEE400172016Medicare PIN
ME262480099Medicaid
MEMM328401Medicare PIN