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Organization
WABANAKI PUBLIC HEALTH AND WELLNESS
Active
Organization
WABANAKI PUBLIC HEALTH AND WELLNESS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHARON MAE JORDAN LCSW (DIRECTOR)
(207) 992-0411
Entity
Organization
Contact information
Practice address
157 PARK ST, BANGOR, ME 04401-5093
(207) 631-1536
(207) 631-0524
Mailing address
PO BOX 1356, BANGOR, ME 04402-1356
(207) 992-0411
(207) 631-0524
Taxonomy
Speciality
Code
Description
License number
State
103TA0400X
Addiction (Substance Use Disorder) Psychologist
Primary
—
NULL
103TA0400X
Addiction (Substance Use Disorder) Psychologist
Primary
—
—
251B00000X
Case Management Agency
—
NULL
251K00000X
Public Health or Welfare Agency
—
NULL
251S00000X
Community/Behavioral Health Agency
—
NULL
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
NULL
Other
Enumeration date
01/06/2022
Last updated
01/06/2022
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