Provider Demographics
NPI:1437269776
Name:WENTWORTH, JANET F (LCSW)
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:F
Last Name:WENTWORTH
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 ELM ST
Mailing Address - Street 2:
Mailing Address - City:KENNEBUNK
Mailing Address - State:ME
Mailing Address - Zip Code:04043-7057
Mailing Address - Country:US
Mailing Address - Phone:207-985-5810
Mailing Address - Fax:
Practice Address - Street 1:73 WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04101-2617
Practice Address - Country:US
Practice Address - Phone:207-771-3500
Practice Address - Fax:207-771-3577
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELC71291041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical