Jordan Ciel Fearon, PSYD

Primary specialty

Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X

License

PS1361 Issued in ME

Practice address

700 Mount Hope Ave Ste 680
Bangor, ME 04401-5672

Phone

(207) 942-9305

NPI assigned

Aug 21, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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.

• Eastern Maine Counseling and Testing Services, Inc.

  • In Home Supportive Care Agency
  • Bangor, ME
  • NPI 1073757266
  NPD (past)

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

{
    "created_epoch": "1440115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710979200000",
    "number": "1356718639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 MOUNT HOPE AVE STE 680",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044015672"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 MOUNT HOPE AVE STE 680",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044015672",
            "telephone_number": "207-942-9305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FEARON",
        "first_name": "JORDAN",
        "middle_name": "CIEL",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-21",
        "last_updated": "2024-03-21",
        "certification_date": "2024-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "ME",
            "license": "PS1361",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "ME",
            "license": "PS1361",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eva V Farrell, CFNP
• Gregg M Farrell, M.D.
• Amina Faruque, MD
• Rebecca Faulkner
• Ameena Fauq, PA-C
• Miranda Jeanne Fearon, LCSW
• Sandra L Feher, OTR/L
• Amy Teresa Fenwick, MD
• Enrique A Feoli, M.D.
• Lori J Ferguson, LCSW

• Clinical Child & Adolescent Psychologist in Bangor, ME
• Providers in Bangor, ME by specialty
• Clinical Child & Adolescent Psychologist in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 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.