Leah Marie Provost, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

CNP241205 Issued in ME

Practice address

224 Malbons Mills Rd
Skowhegan, ME 04976-4137

Phone

(207) 431-8259

NPI assigned

Sep 21, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in ME

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

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.

• State of Maine

  dba Dorothea Dix Psychiatric Center

  • Psychiatric Hospital
  • Bangor, ME
  • NPI 1699776146
  Medicare reassignment NPD
• State of Maine

  dba Riverview Psychiatric Hospital

  • Psychiatric Hospital
  • Augusta, ME
  • NPI 1053319566
  NPD

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

{
    "created_epoch": "1695254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720569600000",
    "number": "1184403958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "224 MALBONS MILLS RD",
            "city": "SKOWHEGAN",
            "state": "ME",
            "postal_code": "049764137",
            "telephone_number": "207-431-8259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "224 MALBONS MILLS RD",
            "city": "SKOWHEGAN",
            "state": "ME",
            "postal_code": "049764137",
            "telephone_number": "207-431-8259"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROVOST",
        "first_name": "LEAH",
        "middle_name": "MARIE",
        "credential": "PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-09-21",
        "last_updated": "2024-07-10",
        "certification_date": "2024-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "ME",
            "license": "CNP241205",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "ME",
            "license": "RN56408",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nathan Pomelow
• Nathaniel J Powers, PHARMD
• Jason M Prada, DPT
• Melody Lynn Pratt, DO
• Oto Prokop, M.D.
• Celeste Cheryll Lopez Quianzon, MD
• Florello Sven-Erik M Quianzon, MD
• Anna Quirion, R.N.
• Rachelle Nunn (Trust In Us LLC)
• Kenneth L Raessler, M.D.

• Psychiatric/Mental Health Nurse Practitioner in Skowhegan, ME
• Providers in Skowhegan, ME by specialty
• Psychiatric/Mental Health Nurse Practitioner in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.