Camille Thayer, LCPC-C

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

XL6247 Issued in ME

Practice address

125 Presumpscot St
Portland, ME 04103-5225

Phone

(207) 871-1000

NPI assigned

Jun 7, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ME

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.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2021

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

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.

• Maine Family Counseling LLC

  • Mental Health Counselor
  • Portland, ME
  • NPI 1699630384
  Medicare reassignment NPD Authorized official
• Cornerstone Behavioral Healthcare, LLC

  • Community/Behavioral Health Agency
  • Bangor, ME
  • NPI 1215102850
  Medicare reassignment NPD

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

{
    "created_epoch": "1623024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623024000000",
    "number": "1235706508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 CAROLINE WAY",
            "city": "SACO",
            "state": "ME",
            "postal_code": "040722184",
            "telephone_number": "207-213-0679"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 PRESUMPSCOT ST",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041035225",
            "telephone_number": "207-871-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THAYER",
        "first_name": "CAMILLE",
        "credential": "LCPC-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-07",
        "last_updated": "2021-06-07",
        "certification_date": "2021-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "ME",
            "license": "XL6247",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Devin Shaughnessy Tetler, AGPCNP-BC
• Alison Moore Tetrault, PMHNP-BC
• Deborah R Tetreault, WHNP
• Colleen Tetzlaff, FNP
• Alison Thaxter
• The Dental Loft
• The Godwin Care Services LLC (GCS)
• The Iris Network
• The Iris Network
• The Jason Program

• Mental Health Counselor in Portland, ME
• Providers in Portland, ME by specialty
• Mental Health Counselor in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2021; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.