Provider Demographics
NPI:1730618059
Name:PRATT, JEAN MARIE (LCPC, LADC, CCS)
Entity type:Individual
Prefix:
First Name:JEAN
Middle Name:MARIE
Last Name:PRATT
Suffix:
Gender:F
Credentials:LCPC, LADC, CCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 258
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:ME
Mailing Address - Zip Code:04351-0258
Mailing Address - Country:US
Mailing Address - Phone:207-292-5512
Mailing Address - Fax:207-292-5124
Practice Address - Street 1:16 ASSOCIATION DRIVE
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:ME
Practice Address - Zip Code:04351-5811
Practice Address - Country:US
Practice Address - Phone:207-292-5512
Practice Address - Fax:207-292-5124
Is Sole Proprietor?:No
Enumeration Date:2017-06-09
Last Update Date:2025-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)