Provider Demographics
NPI:1295935427
Name:PICCINI, JEAN (CADC)
Entity type:Individual
Prefix:MRS
First Name:JEAN
Middle Name:
Last Name:PICCINI
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 1:9 MARCOUX ST
Mailing Address - Street 2:
Mailing Address - City:WINSLOW
Mailing Address - State:ME
Mailing Address - Zip Code:04901-6905
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:70 1ST RANGEWAY
Practice Address - Street 2:
Practice Address - City:WATERVILLE
Practice Address - State:ME
Practice Address - Zip Code:04901-5254
Practice Address - Country:US
Practice Address - Phone:207-616-0705
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-25
Last Update Date:2020-10-15
Deactivation Date:2009-09-10
Deactivation Code:
Reactivation Date:2020-07-28
Provider Licenses
StateLicense IDTaxonomies
MECAC7281101YA0400X
NE8129101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)