Organization
ELLEN JACKSON, LCSW, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ELLEN M. R. JACKSON LCSW (OWNER)
(207) 780-9966
Entity
Organization
Contact information
Practice address
3 FUNDY ROAD, SUITE TWO, FALMOUTH, ME 04105-1796
(207) 780-9966
(207) 780-9966
Mailing address
3 FUNDY ROAD, SUITE TWO, FALMOUTH, ME 04105-1796
(207) 780-9966
(207) 780-9966
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LC1392 ME
ME
Other
Enumeration date
03/20/2008
Last updated
03/20/2008
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