Individual provider Active NPI

Amy Mayhew, LADC

  • Addiction (Substance Use Disorder) Counselor
  • Waterville, ME
National Provider Identifier
1285775767
Registry record updated May 26, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
LC3778 Issued in ME
Practice address
67 Eustis Pkwy
Waterville, ME 04901-5173
Phone
(207) 873-2136
Fax
(207) 872-4522
NPI assigned
Feb 9, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 26, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X LC3778 ME Primary

Addresses

Primary practice location

67 Eustis Pkwy
Waterville, ME 04901-5173

Mailing address

67 Eustis Pkwy
Waterville, ME 04901-5173
Phone (207) 873-2136

Other identifiers 1

IdentifierTypeStateIssuer
432490599MedicaidME

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LC3778MEMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1170979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1274832000000",
    "number": "1285775767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "67 EUSTIS PKWY",
            "city": "WATERVILLE",
            "state": "ME",
            "postal_code": "049015173",
            "telephone_number": "207-873-2136",
            "fax_number": "207-872-4522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "67 EUSTIS PKWY",
            "city": "WATERVILLE",
            "state": "ME",
            "postal_code": "049015173",
            "telephone_number": "207-873-2136",
            "fax_number": "207-872-4522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAYHEW",
        "first_name": "AMY",
        "credential": "LADC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-09",
        "last_updated": "2010-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "ME",
            "license": "LC3778",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "432490599",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterville, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2010; 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.