| Doctor Name: | JILL CHATBURN |
| NPI Number: | 1013158245 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LMSW-CC |
| License Number: | MC10964 |
| Business Practice Address: | 1155 Lisbon St Lewiston, ME - 042405025 |
| Business Phone Number: | 2077839141 |
| Business Fax Number: | |
| Mailing Address: | 78 Atlantic Place, SOUTH PORTLAND |
| State: | ME |
| Postal Code: | 041062316 |
| Phone Number: | 2078426556 |
| Fax Number: | 2078427773 |
| NPI Enumeration Date: | 03/18/2009 |
| NPI Last Update Date: | 06/13/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | MC10964 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | ME |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |