Active NPI
Lucia Patat Young, PH.D.
- Professional Counselor
- Ellsworth, ME
National Provider Identifier
1063575876
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- CC1729
- Practice address
- 114 State St
Ellsworth, ME 04605-1831 - Phone
- (207) 667-4334
- NPI assigned
- Dec 19, 2006
- Last updated
- Jul 9, 2007
- Sex
- Female
- 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 | CC1729 | ME | Primary |
Addresses
Primary practice location
114 State St
Ellsworth, ME 04605-1831
Mailing address
114 State St
Ellsworth, ME 04605-1831
Phone (207) 667-4334
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MT
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240805002264 | MT | Practitioner - Mental Health Counselor | 2668919978 | Practice locations: Missoula, MT |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CC1729 | ME | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166486400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1063575876",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "114 STATE ST",
"city": "ELLSWORTH",
"state": "ME",
"postal_code": "046051831",
"telephone_number": "207-667-4334"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "114 STATE ST",
"city": "ELLSWORTH",
"state": "ME",
"postal_code": "046051831",
"telephone_number": "207-667-4334"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YOUNG",
"first_name": "LUCIA",
"middle_name": "PATAT",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-12-19",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "ME",
"license": "CC1729",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ellsworth, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.