Kimberly M Poland, LCPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

CC3538 Issued in ME

Practice address

165 Lancaster St
Portland, ME 04101-2406

Phone

(207) 956-3258

Fax

(207) 874-1044

NPI assigned

Dec 22, 2009

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

Other names 1

• Mrs. Kimberly M. Cornwall Former name

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, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

MainehealthGroup PAC ID 7517860588, 2,616 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Mainehealth

  • Psychiatric Hospital
  • Westbrook, ME
  • NPI 1790265502
  Medicare reassignment Care Compare group NPD
• Mainehealth

  • Community/Retail Pharmacy
  • Portland, ME
  • NPI 1013868181
  NPD
• Mainehealth

  • Ophthalmology Physician
  • Portland, ME
  • NPI 1730378894
  NPD

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

{
    "created_epoch": "1261440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618963200000",
    "number": "1245569250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "78 ATLANTIC PL",
            "city": "SOUTH PORTLAND",
            "state": "ME",
            "postal_code": "041062316",
            "telephone_number": "207-661-6654",
            "fax_number": "207-842-7773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "165 LANCASTER ST",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041012406",
            "telephone_number": "207-956-3258",
            "fax_number": "207-874-1044"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12 Westbrook Cmn",
            "address_purpose": "LOCATION",
            "city": "Westbrook",
            "state": "ME",
            "postal_code": "040922819",
            "country_code": "US",
            "telephone_number": "207-856-1500",
            "fax_number": "207-856-1518",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "17 Palmer St",
            "address_purpose": "LOCATION",
            "city": "Westbrook",
            "state": "ME",
            "postal_code": "040922132",
            "country_code": "US",
            "telephone_number": "207-239-4485",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POLAND",
        "first_name": "KIMBERLY",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "LCPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-12-22",
        "last_updated": "2021-04-21",
        "certification_date": "2021-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "ME",
            "license": "CC3538",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "CORNWALL",
            "middle_name": "M.",
            "prefix": "MRS.",
            "credential": "LCPC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Megan Marie Poirier-Westman, LADC
• Jacquelyn B. Poirier, MSPT
• Joyce Poirier, CNM
• Matthew D Poirier, CRNA
• Sadie Poirier, FNP
• Fotini Polidoro, CRNA
• David A Polisner, MD
• Dena Lynn Polko, MS SLP
• Jason C Pollard, M.D.
• Laura Jane Lutton Pollard, LMFT

• Professional Counselor in Portland, ME
• Providers in Portland, ME by specialty
• Professional Counselor in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 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.