Doctor Name: | MS. JEAN ANNE FELDEISEN |
NPI Number: | 1396858809 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LCSW, LADC |
License Number: | LC2249 |
Business Practice Address: | 17 Brunswick Avenue Suite 6 Gardiner, ME - 043452123 |
Business Phone Number: | 2075880040 |
Business Fax Number: | 2075880040 |
Mailing Address: | 17 Brunswick Avenue, Suite 6 GARDINER |
State: | ME |
Postal Code: | 043452123 |
Phone Number: | 2075880040 |
Fax Number: | 2075880040 |
NPI Enumeration Date: | 08/17/2006 |
NPI Last Update Date: | 09/29/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | LC2249 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | ME |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |