Provider Demographics
NPI:1245862150
Name:YE, JING (LCPC)
Entity type:Individual
Prefix:
First Name:JING
Middle Name:
Last Name:YE
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:165 CAPTAIN JOHN PARKER RD
Mailing Address - Street 2:
Mailing Address - City:PHIPPSBURG
Mailing Address - State:ME
Mailing Address - Zip Code:04562-4546
Mailing Address - Country:US
Mailing Address - Phone:207-649-7288
Mailing Address - Fax:
Practice Address - Street 1:165 CAPTAIN JOHN PARKER RD
Practice Address - Street 2:
Practice Address - City:PHIPPSBURG
Practice Address - State:ME
Practice Address - Zip Code:04562-4546
Practice Address - Country:US
Practice Address - Phone:207-649-7288
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-08
Last Update Date:2020-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECC1779101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional