Individual provider Active NPI

Julie Susan Marquis, LADC, CCS

  • Addiction (Substance Use Disorder) Counselor
  • Bangor, ME
National Provider Identifier
1083993513
Registry record updated Aug 15, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
LC2227 Issued in ME
Practice address
15 State St
Suite 303
Bangor, ME 04401-5103
Phone
(207) 852-4706
NPI assigned
Aug 15, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 15, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X LC2227 ME Primary
Addiction (Substance Use Disorder) Counselor 101YA0400X CCS3348 ME

Addresses

Primary practice location

15 State St
Suite 303
Bangor, ME 04401-5103

Mailing address

15 State St
Suite 303
Bangor, ME 04401-5103
Phone (207) 852-4706

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
CCS3348MEMDAddiction (Substance Use Disorder) Counselor
LC2227MEMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1313366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1313366400000",
    "number": "1083993513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 STATE ST",
            "address_2": "SUITE 303",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044015103",
            "telephone_number": "207-852-4706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 STATE ST",
            "address_2": "SUITE 303",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044015103",
            "telephone_number": "207-852-4706"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARQUIS",
        "first_name": "JULIE",
        "middle_name": "SUSAN",
        "name_prefix": "Mrs.",
        "credential": "LADC, CCS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-08-15",
        "last_updated": "2011-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "ME",
            "license": "LC2227",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "ME",
            "license": "CCS3348",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bangor, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2011; 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.