Individual provider Active NPI

Michelle Jolin, LCPC-C

  • Community/Behavioral Health Agency
  • Buxton, ME
National Provider Identifier
1164034047
Registry record updated Aug 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
XL5077 Issued in ME
Practice address
207 Town Farm Rd
Buxton, ME 04093-6415
Phone
(207) 838-4891
NPI assigned
Aug 20, 2020
Last updated
Aug 20, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 20, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X XL5077 ME
Community/Behavioral Health Agency 251S00000X XL5077 ME Primary

Addresses

Primary practice location

207 Town Farm Rd
Buxton, ME 04093-6415

Mailing address

207 Town Farm Rd
Buxton, ME 04093-6415
Phone (207) 838-4891

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2016
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

207 Town Farm Rd
Buxton, ME 04093-6415

50 Moody St
Saco, ME 04072-0892

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
XL5077MEMDCommunity/Behavioral Health Agency

NPI Registry JSON

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

{
    "created_epoch": "1597881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597881600000",
    "number": "1164034047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "207 TOWN FARM RD",
            "city": "BUXTON",
            "state": "ME",
            "postal_code": "040936415",
            "telephone_number": "207-838-4891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "207 TOWN FARM RD",
            "city": "BUXTON",
            "state": "ME",
            "postal_code": "040936415",
            "telephone_number": "207-838-4891"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOLIN",
        "first_name": "MICHELLE",
        "credential": "LCPC-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-08-20",
        "last_updated": "2020-08-20",
        "certification_date": "2020-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "ME",
            "license": "XL5077",
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "ME",
            "license": "XL5077",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buxton, ME

Sources for this page

Verify at the official NPI Registry.