| Jackson Cooper, LCSW | |
|
50 Moody St, Saco, ME 04072-1536 | |
| (800) 434-3000 | |
| Not Available |
| Full Name | Jackson Cooper |
|---|---|
| Gender | Male |
| Speciality | Social Worker - Clinical |
| Location | 50 Moody St, Saco, Maine |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215123047 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | LC6541 (Maine) | Primary |
| Entity Name | Kennebec Valley Mental Health Center |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1679504864 PECOS PAC ID: 7113829383 Enrollment ID: O20040127000419 |
| Entity Name | Cornerstone Behavioral Healthcare Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1215102850 PECOS PAC ID: 7214097740 Enrollment ID: O20081113000616 |
| Mailing Address | Practice Location Address |
|---|---|
| Jackson Cooper, LCSW 33 Obrion St, Portland, ME 04101-4411 Ph: () - | Jackson Cooper, LCSW 50 Moody St, Saco, ME 04072-1536 Ph: (800) 434-3000 |
Susan L Wiley, LMSW-CC Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 199 Main St, Saco, ME 04072 Phone: 207-571-3008 Fax: 207-571-3263 | |
Mitchell I. Markowitz, MC9640 Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 50 Moody St, Saco, ME 04072 Phone: 207-294-4657 | |
Allison Krzanowski, LMSW-CC Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 13 Park St, Saco, ME 04072 Phone: 603-969-5233 | |
Susan Paris, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 50 Moody St, Saco, ME 04072 Phone: 207-294-4657 Fax: 207-294-4649 | |
Allison M Carrier, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 50 Moody St, Saco, ME 04072 Phone: 800-434-3000 | |
Caitlin M Nolting, LMSW-CC Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 50 Moody St, Saco, ME 04072 Phone: 800-434-3000 Fax: 207-294-4649 | |
Gabrielle E Sawyer, LMSW-CC Clinical Social Worker Medicare: May Accept Medicare Assignments Practice Location: 50 Moody St, Saco, ME 04072 Phone: 800-434-3000 Fax: 207-294-4649 |