| Jeannie Giberson, Lcsw Llc | |
|
200 High St Portland ME 04101-2831 | |
| (207) 772-0779 | |
| Not Available |
| Full Name | Jeannie Giberson, Lcsw Llc |
|---|---|
| Speciality | Social Worker |
| Location | 200 High St, Portland, Maine |
| Authorized Official Name and Position | Jeannie Elizabeth Giberson (SOLE MEMBER) |
| Authorized Official Contact | 2077720779 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jeannie Giberson, Lcsw Llc 200 High St Portland ME 04101-2831 Ph: (207) 772-0779 | Jeannie Giberson, Lcsw Llc 200 High St Portland ME 04101-2831 Ph: (207) 772-0779 |
| NPI Number | 1326592940 |
|---|---|
| Provider Enumeration Date | 08/11/2016 |
| Last Update Date | 08/11/2016 |
| Medicare PECOS PAC ID | 3678851649 |
|---|---|
| Medicare Enrollment ID | O20161026000117 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326592940 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | LC3054 (Maine) | Primary |
| Provider Name | Jeannie E Giberson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1780722256 PECOS PAC ID: 6608807698 Enrollment ID: I20050830000311 |
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