Individual
JANICE MAE GILLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW-CC
Contact information
Practice address
202 EXCHANGE ST, NEW LIFE MISSION DBA BANGOR COUNSELING CENTER, BANGOR, ME 04401-6508
(207) 941-6434
Mailing address
202 EXCHANGE ST, NEW LIFE MISSION DBA BANGOR COUNSELING CENTER, BANGOR, ME 04401-6508
(207) 941-6434
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
MC11867
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MC11867
BOARD OF SOCIAL WORK LICENSURE
ME
Enumeration date
11/10/2008
Last updated
11/10/2008
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