Individual
LISA TYMESON JUNG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
75 STATE ST, ELLSWORTH, ME 04605-1947
(207) 745-9399
Mailing address
75 STATE ST, ELLSWORTH, ME 04605-1947
(207) 745-9399
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
LC7628
ME
101YM0800X
Mental Health Counselor
Primary
LC7628
ME
Other
Enumeration date
03/19/2010
Last updated
03/19/2010
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