Individual
JESSICA C CARLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCPC
Contact information
Practice address
75 CENTRAL AVE, LEWISTON, ME 04240-6031
(207) 795-4180
(207) 753-6419
Mailing address
PO BOX 10187, ALBANY, NY 12201-5187
(207) 777-4111
(207) 783-6660
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
CC3275
ME
Other
Enumeration date
09/08/2009
Last updated
05/02/2014
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