NPIMap

Individual provider Active NPI

Janice L Kienzle, LCPC

  • Professional Counselor
  • South Portland, ME
National Provider Identifier
1053343897
Registry record updated Jul 24, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
CC4433 Issued in ME
Practice address
884 Broadway Ste 13
South Portland, ME 04106-4371
Phone
(207) 747-8242
NPI assigned
Jul 6, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 24, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X PC002856 PA
Professional Counselor 101YP2500X CC4433 ME Primary

Addresses

Primary practice location

884 Broadway Ste 13
South Portland, ME 04106-4371

Mailing address

884 Broadway Ste 13
South Portland, ME 04106-4371
Phone (207) 747-8242

Other names 1

  • Ms. Janice L Kienzle-Pappalardo Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
CC4433MEMDProfessional Counselor
PC002856PAMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1152144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437696000000",
    "number": "1053343897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "884 BROADWAY STE 13",
            "city": "SOUTH PORTLAND",
            "state": "ME",
            "postal_code": "041064371",
            "telephone_number": "207-747-8242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "884 BROADWAY STE 13",
            "city": "SOUTH PORTLAND",
            "state": "ME",
            "postal_code": "041064371",
            "telephone_number": "207-747-8242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIENZLE",
        "first_name": "JANICE",
        "middle_name": "L",
        "name_prefix": "Ms.",
        "credential": "LCPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-06",
        "last_updated": "2015-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "PA",
            "license": "PC002856",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "ME",
            "license": "CC4433",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JANICE",
            "last_name": "KIENZLE-PAPPALARDO",
            "middle_name": "L",
            "prefix": "MS.",
            "credential": "LCPC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in South Portland, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2015; 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.