Provider Demographics
NPI:1699257782
Name:CALL, JESSE ROBINSON (LCSW)
Entity type:Individual
Prefix:MR
First Name:JESSE
Middle Name:ROBINSON
Last Name:CALL
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:49 CHARLES ST # 1
Mailing Address - Street 2:
Mailing Address - City:BANGOR
Mailing Address - State:ME
Mailing Address - Zip Code:04401-4650
Mailing Address - Country:US
Mailing Address - Phone:207-745-6768
Mailing Address - Fax:207-910-6541
Practice Address - Street 1:49 CHARLES ST # 1
Practice Address - Street 2:
Practice Address - City:BANGOR
Practice Address - State:ME
Practice Address - Zip Code:04401-4650
Practice Address - Country:US
Practice Address - Phone:207-217-4386
Practice Address - Fax:207-910-6541
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-05
Last Update Date:2023-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELC215111041C0700X
MEMC173901041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical