Individual provider Active NPI

Jayme Villanueva, LADC

  • Addiction (Substance Use Disorder) Counselor
  • Old Orchard Beach, ME
National Provider Identifier
1154778397
Registry record updated Jun 2, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
LC6043 Issued in ME
Practice address
28 Portland Ave
Old Orchard Beach, ME 04064-2212
Phone
(207) 937-7001
Fax
(207) 934-5139
NPI assigned
May 18, 2016
Last updated
Jun 2, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X LC6043 ME Primary

Addresses

Primary practice location

28 Portland Ave
Old Orchard Beach, ME 04064-2212

Mailing address

28 Portland Ave
Old Orchard Beach, ME 04064-2212
Phone (207) 937-7001

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
LC6043MEMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1463529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464825600000",
    "number": "1154778397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28 PORTLAND AVE",
            "city": "OLD ORCHARD BEACH",
            "state": "ME",
            "postal_code": "040642212",
            "telephone_number": "207-937-7001",
            "fax_number": "207-934-5139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28 PORTLAND AVE",
            "city": "OLD ORCHARD BEACH",
            "state": "ME",
            "postal_code": "040642212",
            "telephone_number": "207-937-7001",
            "fax_number": "207-934-5139"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILLANUEVA",
        "first_name": "JAYME",
        "credential": "LADC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-18",
        "last_updated": "2016-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "ME",
            "license": "LC6043",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Old Orchard Beach, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 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.

Verify at the official NPI Registry.