Individual provider Active NPI

Beth Cottrell

  • Professional Counselor
  • Bangor, ME
National Provider Identifier
1003458613
Registry record updated Jan 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
CC5830 Issued in ME
Practice address
444 Stillwater Ave Ste 104
Bangor, ME 04401-3500
Phone
(207) 659-6510
NPI assigned
Oct 15, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X CC5830 ME Primary

Addresses

Primary practice location

444 Stillwater Ave Ste 104
Bangor, ME 04401-3500

Mailing address

261 Woodland Ave
Old Town, ME 04468-5925
Phone (207) 356-5478

Other practice location 1

261 Woodland Ave
Old Town, ME 04468-5925
Phone (207) 356-5478

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address beth.cottrell@kidspeace.org
Direct Messaging Address beth.cottrell@kidspeace.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260123000295 ME Practitioner - Mental Health Counselor 3072090885 Practice locations: Bangor, ME

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2005
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

261 Woodland Ave
Old Town, ME 04468-5925

444 Stillwater Ave
Suite 104
Bangor, ME 04401-3500
Phone (207) 659-6510

97 Lincoln St
Apt a
Dover Foxcroft, ME 04426-1329

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CC5830MEMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Megan Elizabeth Smith CurrentSince Oct 27, 2024 Accepting new patients
Cline Chiropractic Center LLC PastSince Jan 29, 2023 Accepting new patients

Locations

444 Stillwater Ave
Ste 104
Bangor, ME 04401
Phone (207) 951-4758

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1571097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674604800000",
    "number": "1003458613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "261 WOODLAND AVE",
            "city": "OLD TOWN",
            "state": "ME",
            "postal_code": "044685925",
            "telephone_number": "207-356-5478"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "444 STILLWATER AVE STE 104",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044013500",
            "telephone_number": "207-659-6510"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "261 Woodland Ave",
            "address_purpose": "LOCATION",
            "city": "Old Town",
            "state": "ME",
            "postal_code": "044685925",
            "country_code": "US",
            "telephone_number": "207-356-5478",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COTTRELL",
        "first_name": "BETH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-15",
        "last_updated": "2023-01-25",
        "certification_date": "2023-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "ME",
            "license": "CC5830",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "beth.cottrell@kidspeace.org",
            "affiliation": "N",
            "address_1": "49 Florida Ave",
            "city": "Bangor",
            "state": "ME",
            "country_code": "US",
            "postal_code": "044013005",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "beth.cottrell@kidspeace.org",
            "affiliation": "N",
            "address_1": "49 Florida Ave",
            "city": "Bangor",
            "state": "ME",
            "country_code": "US",
            "postal_code": "044013005",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bangor, ME

Sources for this page

Verify at the official NPI Registry.