Individual provider Active NPI

Justin Michaud

  • Professional Counselor
  • Bangor, ME
National Provider Identifier
1023400231
Registry record updated Feb 25, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
XL4461 Issued in ME
Practice address
268 Stillwater Ave
Bangor, ME 04401-3945
Phone
(207) 973-6044
NPI assigned
Feb 25, 2015
Last updated
Feb 25, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2015

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 XL4461 ME Primary

Addresses

Primary practice location

268 Stillwater Ave
Bangor, ME 04401-3945

Mailing address

268 Stillwater Ave
Bangor, ME 04401-3945
Phone (207) 973-6044

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME, VA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20240119000545 ME Practitioner - Mental Health Counselor 5597117101 Reassigns benefits to 1 organization
I20240311000375 VA Practitioner - Mental Health Counselor 5597117101 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Thrive Counseling LLCGroup PAC ID 0749458420, 1,187 clinicians

Practice addresses (Care Compare)

1901 E Franklin St
Suite 108
Richmond, VA 23223-6966
Phone (855) 284-7483

550 Forest Ave
Suite 201
Portland, ME 04101-1505
Phone (855) 284-7483

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
XL4461MEMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Thrive Counseling LLC CurrentSince Jan 1, 2024 Accepting new patients

Locations

550 Forest Ave
Ste 201
Portland, ME 04101
Phone (207) 420-2759

1000 Jefferson St
Ste 2C
Lynchburg, VA 24504
Phone (434) 528-3263

1901 E Franklin St
Ste 108
Richmond, VA 23223
Phone (804) 331-2570

5310 Markel Rd
Ste 102
Richmond, VA 23230
Phone (804) 312-5498

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": "1424822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424822400000",
    "number": "1023400231",
    "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": "207-973-6044"
        },
        {
            "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": "207-973-6044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICHAUD",
        "first_name": "JUSTIN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-02-25",
        "last_updated": "2015-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "ME",
            "license": "XL4461",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bangor, ME

Sources for this page

Verify at the official NPI Registry.