Active NPI
Philip Allen Watkins
- Pastoral Counselor
- Augusta, ME
National Provider Identifier
1376935809
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pastoral Counselor
- License
- LP508
- Practice address
- 12 Frog Holler LN
Augusta, ME 04330-0453 - Phone
- (207) 458-4403
- NPI assigned
- Feb 20, 2015
- Sex
- Male
- 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 | LC525 | ME | |
| Pastoral Counselor | 101YP1600X | LP508 | ME | Primary |
Addresses
Primary practice location
12 Frog Holler LN
Augusta, ME 04330-0453
Mailing address
12 Frog Holler LN
Augusta, ME 04330-0453
Phone (207) 458-4403
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
| License | State | Type | Specialty |
|---|---|---|---|
| LC525 | ME | MD | Addiction (Substance Use Disorder) Counselor |
| LP508 | ME | MD | Pastoral Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1424390400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1424390400000",
"number": "1376935809",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12 FROG HOLLER LN",
"city": "AUGUSTA",
"state": "ME",
"postal_code": "043300453",
"telephone_number": "207-458-4403"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12 FROG HOLLER LN",
"city": "AUGUSTA",
"state": "ME",
"postal_code": "043300453",
"telephone_number": "207-458-4403"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WATKINS",
"first_name": "PHILIP",
"middle_name": "ALLEN",
"name_prefix": "Dr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-02-20",
"last_updated": "2015-02-20",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "ME",
"license": "LC525",
"primary": false
},
{
"code": "101YP1600X",
"taxonomy_group": "",
"desc": "Counselor, Pastoral",
"state": "ME",
"license": "LP508",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Augusta, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.