Individual
JEFFREY M. ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MHRT-C & CADC
Contact information
Practice address
88 FOX ST, MADAWASKA, ME 04756-1352
(207) 728-6341
(207) 728-7762
Mailing address
88 FOX ST, MADAWASKA, ME 04756-1352
(207) 728-6341
(207) 728-7762
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
CAC4176
ME
101YM0800X
Mental Health Counselor
Primary
—
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
103850000
MAINE CARE
ME
Enumeration date
02/25/2008
Last updated
06/25/2008
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