Active NPI
Alexander Thorn, LCPC, NCC
- Professional Counselor
- Casco, ME
National Provider Identifier
1053778324
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- CC4918
- Practice address
- 224 Roosevelt TRL
Casco, ME 04015-4228 - Phone
- (207) 577-0972
- NPI assigned
- Jan 18, 2016
- Last updated
- Aug 26, 2024
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | CC4918 | ME | Primary |
Addresses
Primary practice location
224 Roosevelt TRL
Casco, ME 04015-4228
Mailing address
224 Roosevelt TRL
Casco, ME 04015-4228
Phone (207) 577-0972
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
| License | State | Type | Specialty |
|---|---|---|---|
| CC4918 | ME | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Deerspring Wellness, LLC | Professional | Current | Accepting new patients |
Locations
41 Depot St
Ste 203
Bridgton, ME 04009
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.
-
- Professional Counselor
- Casco, ME
- NPI 1851936710
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1453075200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1724630400000",
"number": "1053778324",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "224 ROOSEVELT TRL",
"city": "CASCO",
"state": "ME",
"postal_code": "040154228",
"telephone_number": "207-577-0972"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "224 ROOSEVELT TRL",
"city": "CASCO",
"state": "ME",
"postal_code": "040154228",
"telephone_number": "207-577-0972"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THORN",
"first_name": "ALEXANDER",
"name_prefix": "Mr.",
"credential": "LCPC, NCC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-01-18",
"last_updated": "2024-08-26",
"certification_date": "2024-08-26",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "ME",
"license": "CC4918",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Casco, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 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.