Provider Demographics
NPI:1033532031
Name:PATERSON, JANE FRANCES (LCPC-C, CADC)
Entity Type:Individual
Prefix:MS
First Name:JANE
Middle Name:FRANCES
Last Name:PATERSON
Suffix:
Gender:F
Credentials:LCPC-C, CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:89 WILLOW ST
Mailing Address - Street 2:
Mailing Address - City:SOUTH PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04106-3024
Mailing Address - Country:US
Mailing Address - Phone:207-522-2089
Mailing Address - Fax:
Practice Address - Street 1:222 SAINT JOHN ST
Practice Address - Street 2:SUITE 118
Practice Address - City:PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04102-3000
Practice Address - Country:US
Practice Address - Phone:207-522-2089
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-27
Last Update Date:2014-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECAC5153101YA0400X
MEXL3977101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)