Provider Demographics
NPI:1669421871
Name:FINCK, JENNIFER LYNN (LCSW)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:LYNN
Last Name:FINCK
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 1:32 WOOD AVE
Mailing Address - Street 2:
Mailing Address - City:SACO
Mailing Address - State:ME
Mailing Address - Zip Code:04072-2047
Mailing Address - Country:US
Mailing Address - Phone:207-318-8346
Mailing Address - Fax:
Practice Address - Street 1:198 MAIN ST
Practice Address - Street 2:SUITE 1
Practice Address - City:GORHAM
Practice Address - State:ME
Practice Address - Zip Code:04038-1341
Practice Address - Country:US
Practice Address - Phone:207-318-8346
Practice Address - Fax:207-839-3535
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-08
Last Update Date:2009-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELC98721041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical