Crockett, Jeremy Matthew

Crockett, Jeremy Matthew is an individual health care provider with primary practice located at 629 Main St , Bangor ME 04401-6848. He recently has only one registered license in Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), which is considered as his primary health care specialty. Crockett, Jeremy Matthew can be contacted via phone (207) 990-2870.

Contact Information

Primary practice address
629 Main St Bangor ME 04401-6848
Phone: (207) 990-2870
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X CAC4227 Maine

Profile Details

NPI number 1780986315
LBN Legal business name Crockett, Jeremy Matthew
Credentials CADC
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 2nd, 2010
Last updated Dec 2nd, 2010 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Popular Providers