Jamie Racine

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

JAMIE RACINE

Practice address

28 State St Ste 5
Gorham, ME 04038-1147

Phone

(207) 894-4278

NPI assigned

Jul 6, 2021

Organization subpart

No

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

Authorized official

Name

Jamie Racine, LCSW

Title

Owner

Phone

(207) 894-4278

Specialties & licenses 2

Addresses

Other names 1

• Embrace the Extra Doing business as

Locations

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

{
    "created_epoch": "1625529600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1625788800000",
    "number": "1235700709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28 STATE ST STE 5",
            "city": "GORHAM",
            "state": "ME",
            "postal_code": "040381147",
            "telephone_number": "207-894-4278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28 STATE ST STE 5",
            "city": "GORHAM",
            "state": "ME",
            "postal_code": "040381147",
            "telephone_number": "207-894-4278"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAMIE RACINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-06",
        "last_updated": "2021-07-09",
        "certification_date": "2021-07-09",
        "status": "A",
        "authorized_official_last_name": "RACINE",
        "authorized_official_first_name": "JAMIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "207-894-4278",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Embrace the Extra",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Embrace the Extra",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Michelle L Inman Carlson, LCSW
• Integrated Life LLC
• Integrity Residential Care LLC
• Itetero Care LLC
• Samar Jamali, FNP-C
• Polo Jean-Louis, LCSW
• Jessica Welch LLC
• Lois M. Jones, LCSW
• Sandra Elaine Jose, LSW-C
• Jan L. Juday, MA, CCC-SLP

• Mental Health Clinic/Center (Including Community Mental Health Center) in Gorham, ME
• Providers in Gorham, ME by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2021; 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.