Organization
JODY JANSEN LCSW LLC
Active
Other names
Jody Jansen LCSW
Organization subpart
No
Provider details
NPI number
Authorized official
JODY JANSEN LCSW (CLINICAL SOCIAL WORK)
(207) 251-9118
Entity
Organization
Contact information
Practice address
62 PORTLAND RD, SUITE 6, KENNEBUNK, ME 04043-6658
(207) 251-9118
(207) 517-6241
Mailing address
370 RICHARDS AVE, PORTSMOUTH, NH 03801-5276
(207) 251-9118
(207) 517-6241
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LC5633
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0003644
MEDICARE
ME
Enumeration date
11/13/2014
Last updated
12/01/2016
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