Individual
JENNIFER D WHYNOT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CADC, CTRS, MHRT-C
Contact information
Practice address
1250 FOREST AVE STE 201, PORTLAND, ME 04103-6403
(207) 893-0488
Mailing address
29 SWAN RD, WINDHAM, ME 04062-4520
(207) 899-7866
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LC8279
ME
103TA0400X
Addiction (Substance Use Disorder) Psychologist
Primary
CAC7377
ME
Other
Enumeration date
03/20/2021
Last updated
02/24/2026
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