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NPI Code Detail

MEDICARE: JODI L CHARRON LCSW

MEDICARE: JODI L CHARRON LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social WorkerMC9881ME

General Provider Information

NPI Number : 1770723827
Entity Type Code : Individual
Provider Name (Legal Business Name) : JODI L CHARRON LCSW
Provider Business Mailing Address
First Line : 901 WASHINGTON AVE STE 100
Second Line :
City : PORTLAND
State : ME
Zip : 04103-2842
Country : US
Telephone Number : 207-871-1200
Fax Number : 207-871-1232
Provider Business Practice Location Address
First Line : 901 WASHINGTON AVE STE 100
Second Line :
City : PORTLAND
State : ME
Zip : 04103-2842
Country : US
Telephone Number : 207-871-1200
Fax Number : 207-871-1232
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/03/2009
Last Update Date : 04/25/2023

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Directions to “ JODI L CHARRON LCSW” Practice Location

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