Active NPI
Jayne R. Weisberg, LCPC, LADC
- Mental Health Counselor
- South Portland, ME
National Provider Identifier
1316169295
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- CC3494
- Practice address
- 41 Donald Bean Drive
Suite a
South Portland, ME 04106 - Phone
- (207) 661-6064
- NPI assigned
- May 2, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | LC4348 | ME | |
| Mental Health Counselor | 101YM0800X | CC3494 | ME | Primary |
Addresses
Primary practice location
41 Donald Bean Drive
Suite a
South Portland, ME 04106
Mailing address
34 Christy Road
Portland, ME 04103
Phone (207) 661-6654
Medicare participation
Medicare enrollment files- 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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Mental Health Counselor
- Education
- Other, 2006
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
22 Bramhall St
Portland, ME 04102-3134
Phone (207) 885-9905
41 Donald B Dean Dr
South Portland, ME 04106-3252
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LC4348 | ME | MD | Addiction (Substance Use Disorder) Counselor |
| CC3494 | ME | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mainehealth | Current | Accepting new patients | |
| Mainehealth | Current | Accepting new patients | |
| Mainehealth | Current | Accepting new patients |
Locations
165 Lancaster St
Portland, ME 04101
Phone (207) 874-1030
22 Bramhall St
Portland, ME 04102
Phone (207) 662-2179
78 Atlantic Pl
South Portland, ME 04106
Phone (207) 661-6654
Organizations & group practices 3
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.
-
- Psychiatric Hospital
- Westbrook, ME
- NPI 1790265502
-
- Community/Retail Pharmacy
- Portland, ME
- NPI 1013868181
-
- Community/Behavioral Health Agency
- Portland, ME
- NPI 1265912067
Hospital & facility affiliations 36
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Scarborough, ME
- NPI 1053647024
-
- General Acute Care Hospital
- Portland, ME
- NPI 1346267879
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178064000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1679616000000",
"number": "1316169295",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "34 CHRISTY ROAD",
"city": "PORTLAND",
"state": "ME",
"postal_code": "04103",
"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": "41 DONALD BEAN DRIVE",
"address_2": "SUITE A",
"city": "SOUTH PORTLAND",
"state": "ME",
"postal_code": "04106",
"telephone_number": "207-661-6064"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WEISBERG",
"first_name": "JAYNE",
"middle_name": "R.",
"credential": "LCPC, LADC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-05-02",
"last_updated": "2023-03-24",
"certification_date": "2023-03-24",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "ME",
"license": "LC4348",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "ME",
"license": "CC3494",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in South Portland, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2023; 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.