Provider Demographics
NPI:1154057735
Name:ORNE, JESSICA ROSSE (CADC)
Entity Type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:ROSSE
Last Name:ORNE
Suffix:
Gender:F
Credentials:CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:659 HOGAN RD
Mailing Address - Street 2:
Mailing Address - City:BANGOR
Mailing Address - State:ME
Mailing Address - Zip Code:04401-3626
Mailing Address - Country:US
Mailing Address - Phone:207-973-0400
Mailing Address - Fax:207-973-1881
Practice Address - Street 1:659 HOGAN RD
Practice Address - Street 2:
Practice Address - City:BANGOR
Practice Address - State:ME
Practice Address - Zip Code:04401-3626
Practice Address - Country:US
Practice Address - Phone:207-973-0400
Practice Address - Fax:207-973-1881
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-27
Last Update Date:2022-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECAC8088101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)