Jenna Elizabeth Shank, LCPC-C, NCC
Counselor, Professional in Gorham, ME. Individual provider (NPI-1).
NPI number1609623651
StatusActive
Last updated in NPPESMay 6, 2024
Details
- NPI
- 1609623651
- Entity type
- Individual (NPI-1)
- Name
- Jenna Elizabeth Shank
- Credential
- LCPC-C, NCC
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- May 6, 2024
- Certification date
- May 6, 2024
- Last updated
- May 6, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YP2500X | Counselor, Professional | XL7366 | ME | Yes |
Practice location
37 College AveGorham, ME 04038-1032
Phone 207-780-4052
Mailing address
37 College AveGorham, ME 04038-1032
Phone 207-780-4052
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