Active NPI
Laurienne Missud Martin, LADC
- Addiction (Substance Use Disorder) Counselor
- North Berwick, ME
National Provider Identifier
1083158356
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- LC4443
- Practice address
- 155 Elm St
North Berwick, ME 03906-7100 - Phone
- (207) 651-7573
- NPI assigned
- Dec 6, 2016
- 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 |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | LC4443 | ME | Primary |
Addresses
Primary practice location
155 Elm St
North Berwick, ME 03906-7100
Mailing address
155 Elm St
North Berwick, ME 03906-7100
Phone (207) 651-7573
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 |
|---|---|---|---|
| LC4443 | ME | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1480982400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1480982400000",
"number": "1083158356",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "155 ELM ST",
"city": "NORTH BERWICK",
"state": "ME",
"postal_code": "039067100",
"telephone_number": "207-651-7573"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "155 ELM ST",
"city": "NORTH BERWICK",
"state": "ME",
"postal_code": "039067100",
"telephone_number": "207-651-7573"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MISSUD MARTIN",
"first_name": "LAURIENNE",
"credential": "LADC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-12-06",
"last_updated": "2016-12-06",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "ME",
"license": "LC4443",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in North Berwick, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.