Jarrod Joseph Widor, PMHRN-BC

Primary specialty

Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0808X

License

RN76959 Issued in ME

Practice address

66 Stone St
Augusta, ME 04330-5227

Phone

(207) 626-3455

NPI assigned

Mar 9, 2011

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Kennebec Valley Mental Health Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Waterville, ME
  • NPI 1679504864
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1299628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709596800000",
    "number": "1316245756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "66 STONE ST",
            "city": "AUGUSTA",
            "state": "ME",
            "postal_code": "043305227",
            "telephone_number": "207-626-3455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "66 STONE ST",
            "city": "AUGUSTA",
            "state": "ME",
            "postal_code": "043305227",
            "telephone_number": "207-626-3455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIDOR",
        "first_name": "JARROD",
        "middle_name": "JOSEPH",
        "credential": "PMHRN-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-03-09",
        "last_updated": "2024-03-05",
        "certification_date": "2024-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "ME",
            "license": "RN76959",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michele White, RN-BC
• Christopher George Whitehead, RPH
• David Bruce Whitestone, PHD
• Leah M Whitten, RN
• David John Wicks, DDS
• Taylor Wienckowski
• Joel Thomas Wiggin, CHAPLIN
• Elizabeth A Wilbur, LSW-C
• Amber Willett, LMSW-CC
• Tina Marie Willette, COTA

• Psychiatric/Mental Health Registered Nurse in Augusta, ME
• Providers in Augusta, ME by specialty
• Psychiatric/Mental Health Registered Nurse in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.