Michael Pepin, LMSW-CC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

1053467779 Issued in NU

Practice address

280B Gannett Dr
South Portland, ME 04106-6940

Phone

(207) 828-0048

Fax

(207) 756-6228

NPI assigned

Aug 17, 2018

Last updated

Aug 17, 2018By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Port Resources

  • Intellectual and/or Developmental Disabilities Residential Treatment Facility
  • South Portland, ME
  • NPI 1053467779
  NPD (past)

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

{
    "created_epoch": "1534464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534464000000",
    "number": "1053891218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 CASCO TER APT 3",
            "city": "FALMOUTH",
            "state": "ME",
            "postal_code": "041051524",
            "telephone_number": "207-355-5101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "280B GANNETT DR",
            "city": "SOUTH PORTLAND",
            "state": "ME",
            "postal_code": "041066940",
            "telephone_number": "207-828-0048",
            "fax_number": "207-756-6228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEPIN",
        "first_name": "MICHAEL",
        "name_prefix": "Mr.",
        "credential": "LMSW-CC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-08-17",
        "last_updated": "2018-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": "1053467779",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Peace Residential Care LLC
• Peace Residential Services
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• Maria D Pedro
• Julie E Pelletier, MD
• Maegan Perrault, MS, RD, LD
• Laura Pescatore
• Peter F Morse Inc
• Alexander C Philiphose, D.C.
• Kristen F. Pierce, LCPC

• Mental Health Counselor in South Portland, ME
• Providers in South Portland, ME by specialty
• Mental Health Counselor in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2018; 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.