| Doctor Name: | JENIFER E MASCARO |
| NPI Number: | 1205123692 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LCPCC, LADC |
| License Number: | LC4388 |
| Business Practice Address: | 1 Delta Dr Westbrook, ME - 040924745 |
| Business Phone Number: | 2078567227 |
| Business Fax Number: | 2078562112 |
| Mailing Address: | 1 Delta Dr, WESTBROOK |
| State: | ME |
| Postal Code: | 040924745 |
| Phone Number: | 2078567227 |
| Fax Number: | 2078562112 |
| NPI Enumeration Date: | 07/06/2011 |
| NPI Last Update Date: | 07/06/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | LC4388 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | ME |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |