Individual
JENNIFER C WOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LADC, LCSW, CCS
Contact information
Practice address
300 PINE ST, LEWISTON, ME 04240-6309
(207) 777-3399
(207) 777-3391
Mailing address
300 PINE ST, LEWISTON, ME 04240-6309
(207) 777-3399
(207) 777-3391
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
LC2287
ME
1041C0700X
Clinical Social Worker
Primary
LC10560
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
253490099
—
ME
Enumeration date
03/26/2008
Last updated
11/02/2009
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