Provider Demographics
NPI:1699113282
Name:CROY, JEANNE H (MSW)
Entity type:Individual
Prefix:
First Name:JEANNE
Middle Name:H
Last Name:CROY
Suffix:
Gender:F
Credentials:MSW
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 1081
Mailing Address - Street 2:
Mailing Address - City:ALFRED
Mailing Address - State:ME
Mailing Address - Zip Code:04002-1081
Mailing Address - Country:US
Mailing Address - Phone:207-502-0056
Mailing Address - Fax:
Practice Address - Street 1:469 MAIN ST STE 304
Practice Address - Street 2:
Practice Address - City:SPRINGVALE
Practice Address - State:ME
Practice Address - Zip Code:04083-1872
Practice Address - Country:US
Practice Address - Phone:207-502-0056
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-05
Last Update Date:2019-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELC141811041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical