Individual provider Active NPI

Matthew Haviland

  • Mental Health Counselor
  • Seal Cove, ME
National Provider Identifier
1114646296
Registry record updated Aug 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
XL6762 Issued in ME
Practice address
37 Cape Rd
Seal Cove, ME 04674-4451
Phone
(207) 266-5770
NPI assigned
Aug 23, 2022
Last updated
Aug 23, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X XL6762 ME Primary

Addresses

Primary practice location

37 Cape Rd
Seal Cove, ME 04674-4451

Mailing address

37 Cape Rd
Seal Cove, ME 04674-4451
Phone (207) 266-5770

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240905004396 ME Practitioner - Mental Health Counselor 3072053966 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Acadia Hospital Corp.Group PAC ID 7719878495, 88 clinicians

Practice addresses (Care Compare)

268 Stillwater Ave
Bangor, ME 04401-3945
Phone (207) 973-6100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
XL6762MEMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Acadia Hospital Corp CurrentSince Jul 18, 2024 Accepting new patients

Locations

268 Stillwater Ave
Bangor, ME 04401
Phone (207) 973-6470

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.

NPI Registry JSON

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

{
    "created_epoch": "1661212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661212800000",
    "number": "1114646296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "37 CAPE RD",
            "city": "SEAL COVE",
            "state": "ME",
            "postal_code": "046744451",
            "telephone_number": "207-266-5770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "37 CAPE RD",
            "city": "SEAL COVE",
            "state": "ME",
            "postal_code": "046744451",
            "telephone_number": "207-266-5770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAVILAND",
        "first_name": "MATTHEW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-08-23",
        "last_updated": "2022-08-23",
        "certification_date": "2022-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "ME",
            "license": "XL6762",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Sources for this page

Verify at the official NPI Registry.