| Ellen Jackson, Lcsw, Llc | |
|
3 Fundy Road Suite Two Falmouth ME 04105-1796 | |
| (207) 780-9966 | |
| (207) 780-9966 |
| Full Name | Ellen Jackson, Lcsw, Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 3 Fundy Road, Falmouth, Maine |
| Authorized Official Name and Position | Ellen M. R. Jackson (OWNER) |
| Authorized Official Contact | 2077809966 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ellen Jackson, Lcsw, Llc 3 Fundy Road Suite Two Falmouth ME 04105-1796 Ph: (207) 780-9966 | Ellen Jackson, Lcsw, Llc 3 Fundy Road Suite Two Falmouth ME 04105-1796 Ph: (207) 780-9966 |
| NPI Number | 1104097948 |
|---|---|
| Provider Enumeration Date | 03/20/2008 |
| Last Update Date | 03/20/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104097948 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | LC1392 ME (Maine) | Primary |
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