Jessica Demerise Small, LCPC | |
202 Exchange St, Bangor, ME 04401-6508 | |
(207) 941-6434 | |
(207) 941-9366 |
Full Name | Jessica Demerise Small |
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Gender | Female |
Speciality | Counselor - Mental Health |
Location | 202 Exchange St, Bangor, Maine |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1033540687 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YM0800X | Counselor - Mental Health | XL4254 (Maine) | Primary |
Entity Name | Health Affiliates Maine, Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1932413556 PECOS PAC ID: 1951594076 Enrollment ID: O20101021000912 |
Mailing Address | Practice Location Address |
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Jessica Demerise Small, LCPC 202 Exchange St, Bangor, ME 04401-6508 Ph: (207) 941-6434 | Jessica Demerise Small, LCPC 202 Exchange St, Bangor, ME 04401-6508 Ph: (207) 941-6434 |
Joan Reinholdtsen, Counselor Medicare: Medicare Enrolled Practice Location: 157 Park St, Bangor, ME 04401 Phone: 207-992-0410 | |
Emily A Goode, LCPC Counselor Medicare: Medicare Enrolled Practice Location: 86 Davis Rd, Bangor, ME 04401 Phone: 207-992-2205 Fax: 207-992-2207 | |
Beth Cottrell, Counselor Medicare: Not Enrolled in Medicare Practice Location: 444 Stillwater Ave Ste 104, Bangor, ME 04401 Phone: 207-659-6510 | |
Melissa Leary, ADCA Counselor Medicare: Not Enrolled in Medicare Practice Location: 689 Odlin Rd, Bangor, ME 04401 Phone: 207-947-6800 | |
Mrs. Debbie Lynn Webber, MED, LCPC, NCC Counselor Medicare: Not Enrolled in Medicare Practice Location: 24 Springer Road, 1 Springer Place Suite 202, Bangor, ME 04401 Phone: 207-992-2535 Fax: 207-992-2539 | |
Nicholas Jon Pelkey, LADC Counselor Medicare: Not Enrolled in Medicare Practice Location: 96 Harlow St, Suite 360, Bangor, ME 04401 Phone: 207-945-9777 Fax: 207-945-9780 | |
Amanda Elliott, ADCA Counselor Medicare: Not Enrolled in Medicare Practice Location: 689 Odlin Rd Ste 1, Bangor, ME 04401 Phone: 207-947-6800 |