NPIMap

Organization Active NPI

Mint Condition Counseling, LLC

  • Clinical Social Worker
  • Westbrook, ME
National Provider Identifier
1205583895
Registry record updated Dec 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
MINT CONDITION COUNSELING, LLC
Practice address
40 Brackett St Apt 3
Westbrook, ME 04092-3383
Phone
(603) 860-4900
NPI assigned
Mar 3, 2022
Last updated
Dec 22, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2022

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

Authorized official

Name
Nicole E Blake, LCSW, LADCNPI 1962022350
Title
Sole Member/Owner
Phone
(603) 860-4900

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X NU
Addiction (Substance Use Disorder) Counselor 101YA0400X NU
Clinical Social Worker 1041C0700X NU Primary

Addresses

Primary practice location

40 Brackett St Apt 3
Westbrook, ME 04092-3383

Mailing address

40 Brackett St Apt 3
Westbrook, ME 04092-3383
Phone (603) 860-4900

Other identifiers 1

IdentifierTypeStateIssuer
2077079813OtherINDIV NPI

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address nicole@mintconditioncounseling.com Direct

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1646265600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1671667200000",
    "number": "1205583895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 BRACKETT ST APT 3",
            "city": "WESTBROOK",
            "state": "ME",
            "postal_code": "040923383",
            "telephone_number": "603-860-4900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 BRACKETT ST APT 3",
            "city": "WESTBROOK",
            "state": "ME",
            "postal_code": "040923383",
            "telephone_number": "603-860-4900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINT CONDITION COUNSELING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-03",
        "last_updated": "2022-12-22",
        "certification_date": "2022-12-22",
        "status": "A",
        "authorized_official_last_name": "BLAKE",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "SOLE MEMBER/OWNER",
        "authorized_official_telephone_number": "603-860-4900",
        "authorized_official_credential": "LCSW, LADC"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIV NPI",
            "identifier": "2077079813",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nicole@mintconditioncounseling.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "40 Brackett St Apt 3",
            "city": "Westbrook",
            "state": "ME",
            "country_code": "US",
            "postal_code": "040923383",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Westbrook, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2022; 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.