| Jody Jansen Lcsw | |
|
62 Portland Rd Suite 6 Kennebunk ME 04043-6658 | |
| (207) 251-9118 | |
| (207) 517-6241 |
| Full Name | Jody Jansen Lcsw |
|---|---|
| Speciality | Social Worker |
| Location | 62 Portland Rd, Kennebunk, Maine |
| Authorized Official Name and Position | Jody Jansen (CLINICAL SOCIAL WORK) |
| Authorized Official Contact | 2072519118 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jody Jansen Lcsw 370 Richards Ave Portsmouth NH 03801-5276 Ph: (207) 251-9118 | Jody Jansen Lcsw 62 Portland Rd Suite 6 Kennebunk ME 04043-6658 Ph: (207) 251-9118 |
| NPI Number | 1871999193 |
|---|---|
| Provider Enumeration Date | 11/13/2014 |
| Last Update Date | 12/01/2016 |
| Medicare PECOS PAC ID | 5890011977 |
|---|---|
| Medicare Enrollment ID | O20150309000738 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871999193 | NPI | - | NPPES |
| 0003644 | Other | ME | MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | LC5633 (Maine) | Primary |
| Provider Name | Jody A Jansen |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1407901473 PECOS PAC ID: 4981794377 Enrollment ID: I20071222000022 |
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