Individual
JENNI E. DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW, CADC
Contact information
Practice address
165 LANCASTER STREET, PORTLAND, ME 04101-2406
(207) 874-1030
(207) 874-1044
Mailing address
78 ATLANTIC PLACE, SOUTH PORTLAND, ME 04106-2316
(207) 661-6654
(207) 842-7773
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
CAC4311
ME
1041C0700X
Clinical Social Worker
Primary
LC12418
ME
Other
Enumeration date
01/31/2007
Last updated
06/22/2016
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