NPIMap

Organization Active NPI

Jamie Racine

Doing business as Embrace the Extra

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Gorham, ME
National Provider Identifier
1235700709
Registry record updated Jul 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
JAMIE RACINE
Doing business as
Embrace the Extra
Practice address
28 State St Ste 5
Gorham, ME 04038-1147
Phone
(207) 894-4278
NPI assigned
Jul 6, 2021
Last updated
Jul 9, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2021

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

Authorized official

Name
Jamie Racine, LCSWNPI 1508103052
Title
Owner
Phone
(207) 894-4278

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

28 State St Ste 5
Gorham, ME 04038-1147

Mailing address

28 State St Ste 5
Gorham, ME 04038-1147
Phone (207) 894-4278

Other names 1

  • Embrace the Extra Doing business as

National Provider Directory

National Provider Directory

Locations

28 State St
Ste 5
Gorham, ME 04038
Phone (207) 222-0299

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": "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"
        }
    ]
}

Other providers in Gorham, ME

Sources for this page

  • 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.