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General NPI Number Information
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NPI Number | 1720399124
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Entity Type | Individual
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Provider Name | PATRICIA JOLLOTTA LCPC
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Gender | Female
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Dates
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Enumeration Date | 06/30/2010
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Last Update Date | 04/09/2024
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Provider Practice Location Address
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Address Line | 127 PALMER ST
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City | CALAIS
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State | ME
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Zip | 04619-1300
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Country | US
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Telephone | 207-454-0270
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Fax | 72-454-0232
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Provider Business Mailing Address
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Address Line | 180 ACADEMY ST STE 3
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City | PRESQUE ISLE
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State | ME
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Zip | 04769-3183
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Country | US
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Telephone | 207-554-2352
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Fax | 907-543-7101
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State | AK
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 666
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License Number State | AK
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Taxonomy #3
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | CC6159
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License Number State | ME
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