IndividualActive
Jesse Russell, L.C.S.W.
NPI 1235319880 · Clinical Social Worker · Freeport, ME
Provider details
- NPI number
- 1235319880
- Entity type
- Individual
- Primary specialty
- Clinical Social WorkerBehavioral Health & Social Service Providers
- Credential
- L.C.S.W.
- Sex
- Male
- Sole proprietor
- Yes
- License
- LC 5397 (ME)
Specialties & taxonomies
Behavioral Health & Social Service Providers
Practice location
106 Maquoit Dr
Freeport, ME 04032-6320
Phone: (207) 671-5598
Approximate (ZIP-level) locationGet directions
Mailing address
Po Box 597
Freeport, ME 04032-0597
Registry dates
- Enumerated
- 2007-11-13
- Last updated
- 2025-09-10
- Certified
- 2025-09-10
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.