Individual provider Active NPI

Jennifer M Tracey, LMFT

  • Marriage & Family Therapist
  • Bangor, ME
National Provider Identifier
1023316312
Registry record updated Mar 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MF4649 Issued in ME
Practice address
268 Stillwater Ave
Bangor, ME 04401-3945
Phone
(207) 973-6100
NPI assigned
Mar 10, 2011
Last updated
Mar 18, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 18, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X MF4649 ME Primary

Addresses

Primary practice location

268 Stillwater Ave
Bangor, ME 04401-3945

Mailing address

268 Stillwater Ave
Bangor, ME 04401-3945
Phone (207) 973-6100

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
I20250527002244 ME Practitioner - Marriage and Family Therapist 5890214522 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Acadia Hospital Corp.Group PAC ID 7719878495, 88 clinicians

Practice addresses (Care Compare)

268 Stillwater Ave
Bangor, ME 04401-3945
Phone (207) 973-6100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MF4649MEMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Acadia Hospital Corp CurrentSince Mar 30, 2025 Accepting new patients

Locations

268 Stillwater Ave
Bangor, ME 04401
Phone (207) 973-6470

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1299715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742256000000",
    "number": "1023316312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "268 STILLWATER AVE",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044013945",
            "telephone_number": "207-973-6100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "268 STILLWATER AVE",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044013945",
            "telephone_number": "207-973-6100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRACEY",
        "first_name": "JENNIFER",
        "middle_name": "M",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-03-10",
        "last_updated": "2025-03-18",
        "certification_date": "2025-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "ME",
            "license": "MF4649",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bangor, ME

Sources for this page

Verify at the official NPI Registry.