Provider Demographics
NPI:1235845983
Name:JANIE J. GENDRON, LCSW, PLLC
Entity Type:Organization
Organization Name:JANIE J. GENDRON, LCSW, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:JANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:GENDRON
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:207-337-1778
Mailing Address - Street 1:427 CIDER HILL RD
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:ME
Mailing Address - Zip Code:03909-5306
Mailing Address - Country:US
Mailing Address - Phone:207-337-1778
Mailing Address - Fax:
Practice Address - Street 1:1 VARRELL LN STE 18
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:ME
Practice Address - Zip Code:03909-1058
Practice Address - Country:US
Practice Address - Phone:207-337-1778
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-26
Last Update Date:2023-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health