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Individual

JEREMY THOMAS ROBICHAUD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LCSW

Contact information

Practice address
100 S JUNIPER ST FL 3, PHILADELPHIA, PA 19107-1316
(267) 999-9534
(833) 613-2680
Mailing address
268 STILLWATER AVE, BANGOR, ME 04401-3945
(207) 973-6100

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
44SC06189300
NJ
1041C0700X
Clinical Social Worker
Primary
CW023345
PA
1041C0700X
Clinical Social Worker
LC18703
ME

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
4033201519
ME
Enumeration date
11/04/2017
Last updated
07/12/2023
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