Search › Maine › 101YA0400X
Jason Nickerson, CADC
NPI 1841722378 · on the registry since 2017
Practice
- Address
- 72 Auburn St
Portland, ME 04103 - Phone
- (207) 245-1800
- Fax
- (207) 899-1599
- Organisation at this address
- Grace Street Services, Llc
Inferred from a shared address, not stated in the registry.
- Clinicians at this address
- 2
Registry record
- Primary taxonomy
- 101YA0400X
101YA0400X
- Licence states on file
- ME
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2017-04-03
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Maine