Provider Demographics
NPI:1487368627
Name:JAYNES, EKATRINA (LCSW, MBA)
Entity type:Individual
Prefix:MS
First Name:EKATRINA
Middle Name:
Last Name:JAYNES
Suffix:
Gender:F
Credentials:LCSW, MBA
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 104
Mailing Address - Street 2:
Mailing Address - City:BELGRADE
Mailing Address - State:ME
Mailing Address - Zip Code:04917-0104
Mailing Address - Country:US
Mailing Address - Phone:207-314-1105
Mailing Address - Fax:
Practice Address - Street 1:7 PICKEREL LANE
Practice Address - Street 2:
Practice Address - City:BELGRADE
Practice Address - State:ME
Practice Address - Zip Code:04917
Practice Address - Country:US
Practice Address - Phone:207-314-1105
Practice Address - Fax:207-660-4529
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-12
Last Update Date:2025-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELC122821041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical