Provider Demographics
NPI:1750607164
Name:GENDRON, JANIE JAMES (LCSW)
Entity type:Individual
Prefix:MS
First Name:JANIE
Middle Name:JAMES
Last Name:GENDRON
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 1:427 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:
Is Sole Proprietor?:No
Enumeration Date:2010-04-09
Last Update Date:2023-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELC79181041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical