Provider Demographics
NPI:1205957719
Name:NERO, NANNETTE A (MS, CAGS, LMFT)
Entity type:Individual
Prefix:MS
First Name:NANNETTE
Middle Name:A
Last Name:NERO
Suffix:
Gender:F
Credentials:MS, CAGS, LMFT
Other - Prefix:MS
Other - First Name:NANNETTE
Other - Middle Name:A
Other - Last Name:NERO ZUKE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, CAGS, LMFT
Mailing Address - Street 1:PO BOX 48
Mailing Address - Street 2:
Mailing Address - City:BIDDEFORD
Mailing Address - State:ME
Mailing Address - Zip Code:04005-0048
Mailing Address - Country:US
Mailing Address - Phone:207-985-5580
Mailing Address - Fax:207-985-5580
Practice Address - Street 1:62 PORTLAND RD
Practice Address - Street 2:SUITE 6
Practice Address - City:KENNEBUNK
Practice Address - State:ME
Practice Address - Zip Code:04043-6650
Practice Address - Country:US
Practice Address - Phone:207-985-5580
Practice Address - Fax:207-985-5580
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-02
Last Update Date:2016-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEMF1940106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME431596000Medicaid
ME431596000Medicaid