Individual
MS. JEAN ANNE FELDEISEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW, LADC
Contact information
Practice address
17 BRUNSWICK AVENUE, SUITE 6, GARDINER, ME 04345-2123
(207) 588-0040
(207) 588-0040
Mailing address
17 BRUNSWICK AVENUE, SUITE 6, GARDINER, ME 04345-2123
(207) 588-0040
(207) 588-0040
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
LC2249
ME
104100000X
Social Worker
Primary
LC8044
ME
1041C0700X
Clinical Social Worker
LC8044
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
100374
ANTHEM
ME
05
—
305540099
—
ME
Enumeration date
08/17/2006
Last updated
09/29/2010
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