| Colleen Jillson Counseling Services Llc | |
|
168 Lisbon St Unit 4 Lewiston ME 04240-7234 | |
| (207) 312-8614 | |
| (207) 223-3691 |
| Full Name | Colleen Jillson Counseling Services Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 168 Lisbon St Unit 4, Lewiston, Maine |
| Authorized Official Name and Position | Colleen Jillson (OWNER) |
| Authorized Official Contact | 2073128614 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Colleen Jillson Counseling Services Llc Po Box 7111 Lewiston ME 04243-7111 Ph: (207) 312-8614 | Colleen Jillson Counseling Services Llc 168 Lisbon St Unit 4 Lewiston ME 04240-7234 Ph: (207) 312-8614 |
| NPI Number | 1780331520 |
|---|---|
| Provider Enumeration Date | 03/02/2022 |
| Last Update Date | 07/05/2022 |
| Certification Date | 07/05/2022 |
| Medicare PECOS PAC ID | 4688049224 |
|---|---|
| Medicare Enrollment ID | O20230412001556 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780331520 | NPI | - | NPPES |
| 1851665939 | Medicaid | ME |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Colleen G Jillson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1851665939 PECOS PAC ID: 4183985732 Enrollment ID: I20180223000588 |
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