Provider Demographics
NPI:1124182241
Name:KREBS, JEFFREY SCOTT (PHD)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:SCOTT
Last Name:KREBS
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 777
Mailing Address - Street 2:
Mailing Address - City:PARSONSFIELD
Mailing Address - State:ME
Mailing Address - Zip Code:04047
Mailing Address - Country:US
Mailing Address - Phone:207-625-8126
Mailing Address - Fax:207-625-7820
Practice Address - Street 1:70 MAIN STREET
Practice Address - Street 2:
Practice Address - City:PORTER
Practice Address - State:ME
Practice Address - Zip Code:04068
Practice Address - Country:US
Practice Address - Phone:207-625-8126
Practice Address - Fax:207-625-7820
Is Sole Proprietor?:No
Enumeration Date:2006-12-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEOS922103TC0700X
CT000582103TC0700X
NY004751103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical