Provider Demographics
NPI:1003240508
Name:DELMONACO, JANE E (RNC, CADC)
Entity Type:Individual
Prefix:
First Name:JANE
Middle Name:E
Last Name:DELMONACO
Suffix:
Gender:F
Credentials:RNC, CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 BEECH ST
Mailing Address - Street 2:
Mailing Address - City:CALAIS
Mailing Address - State:ME
Mailing Address - Zip Code:04619
Mailing Address - Country:US
Mailing Address - Phone:207-454-1300
Mailing Address - Fax:207-454-1332
Practice Address - Street 1:12 BEECH ST
Practice Address - Street 2:
Practice Address - City:CALAIS
Practice Address - State:ME
Practice Address - Zip Code:04619-1203
Practice Address - Country:US
Practice Address - Phone:207-454-1300
Practice Address - Fax:207-454-1332
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-03
Last Update Date:2013-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECAC3562101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)