Travis C Durepo, LCPC CONDITIONAL

Primary specialty

CounselorTaxonomy code 101Y00000X

License

XL4038 Issued in ME

Practice address

658 Main St Ste 1
Caribou, ME 04736-4461

Phone

(207) 492-9003

Fax

(855) 553-6925

NPI assigned

Sep 26, 2012

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

Other identifiers 1

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

Specialty

Mental Health Counselor

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

SweetserGroup PAC ID 8325946213, 138 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Sweetser

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Saco, ME
  • NPI 1538122445
  Medicare reassignment Care Compare group NPD
• Life by Design, PA

  • Clinical Social Worker
  • Presque Isle, ME
  • NPI 1053345918
  NPD (past)
• Pathways Wellness Group, LLP

  • Mental Health Counselor
  • Caribou, ME
  • NPI 1568120111
  NPD (past)

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

{
    "created_epoch": "1348617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638316800000",
    "number": "1134470438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "658 MAIN ST STE 1",
            "city": "CARIBOU",
            "state": "ME",
            "postal_code": "047364461",
            "telephone_number": "207-492-0903",
            "fax_number": "855-553-6925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "658 MAIN ST STE 1",
            "city": "CARIBOU",
            "state": "ME",
            "postal_code": "047364461",
            "telephone_number": "207-492-9003",
            "fax_number": "855-553-6925"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUREPO",
        "first_name": "TRAVIS",
        "middle_name": "C",
        "credential": "LCPC CONDITIONAL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-09-26",
        "last_updated": "2021-12-01",
        "certification_date": "2021-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "ME",
            "license": "XL4038",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF MAINE",
            "identifier": "CC5725",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Megan Doody, LMSW-CC
• Maria J Dubois, MHRT-CSP
• Jeremy Dugal, P.T.
• Chantal Dumais
• Stephanie C, Dumond
• Eastern Aroostook Regional School
• Eastern Maine Homecare
• Eastern Maine Homecare
• Eastern Maine Homecare
• Lori Eckerstorfer, PAC

• Counselor in Caribou, ME
• Providers in Caribou, ME by specialty
• Counselor in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2021; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.