| Doctor Name: | JILL MERTINKE |
| NPI Number: | 1558483982 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LCPC |
| License Number: | CC2367 |
| Business Practice Address: | 25 Main St Suite #8 Machias, ME - 046541165 |
| Business Phone Number: | 2072554833 |
| Business Fax Number: | |
| Mailing Address: | 45 Ell Point Rd, EAST MACHIAS |
| State: | ME |
| Postal Code: | 046303841 |
| Phone Number: | 2072554833 |
| Fax Number: | |
| NPI Enumeration Date: | 04/05/2007 |
| NPI Last Update Date: | 09/20/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | CC2367 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | ME |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |