Jacob M Wisecup, LMSW-CC
Jacob M Wisecup, LMSW-CC is a Clinical Social Worker in Portland, Maine. Licensed in Maine. Registered with an NPI since 2020.
- Licensed in
- ME
- In the registry since
- 2020
Practice location Address checks out
901 Washington Ave Ste 100Portland, ME 04103-2842
Phone: (207) 871-1200
Fax: (207) 871-1232
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Clinical Social Worker (primary) | Taxonomy 1041C0700X · Licence MC19315 (ME) |
|---|
Record details
| NPI number | 1992392914 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Credentials | LMSW-CC |
| Sole proprietor | No |
| NPI enumerated | December 23, 2020 |
| Last updated in NPPES | December 23, 2020 |
| Certification date | December 23, 2020 |
| Mailing address | 901 Washington Ave Ste 100, Portland, ME 04103-2842 |
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