Individual provider Active NPI

Tom Kivler, LCPC

  • Professional Counselor
  • Brunswick, ME
National Provider Identifier
1336286046
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
CC670 Issued in ME
Practice address
66 Baribeau Dr
Suite 8
Brunswick, ME 04011-3230
Phone
(207) 373-6971
Fax
(207) 373-6959
NPI assigned
Jan 31, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X CC670 ME Primary

Addresses

Primary practice location

66 Baribeau Dr
Suite 8
Brunswick, ME 04011-3230

Mailing address

66 Baribeau Dr
Suite 8
Brunswick, ME 04011-3230
Phone (207) 373-6971

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
CC670MEMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1170201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1336286046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "66 BARIBEAU DR",
            "address_2": "SUITE 8",
            "city": "BRUNSWICK",
            "state": "ME",
            "postal_code": "040113230",
            "telephone_number": "207-373-6971",
            "fax_number": "207-373-6959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "66 BARIBEAU DR",
            "address_2": "SUITE 8",
            "city": "BRUNSWICK",
            "state": "ME",
            "postal_code": "040113230",
            "telephone_number": "207-373-6971",
            "fax_number": "207-373-6959"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIVLER",
        "first_name": "TOM",
        "credential": "LCPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-31",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "ME",
            "license": "CC670",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brunswick, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.