Active NPI
Tibby York-Longpre, LADC
- Addiction (Substance Use Disorder) Counselor
- Lewiston, ME
National Provider Identifier
1407018153
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- LC2470
- Practice address
- 11 Lisbon St
Suite 105
Lewiston, ME 04240-7198 - Phone
- (207) 783-3574
- NPI assigned
- Jun 25, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | LC2470 | ME | Primary |
Addresses
Primary practice location
11 Lisbon St
Suite 105
Lewiston, ME 04240-7198
Mailing address
11 Lisbon St
Suite 105
Lewiston, ME 04240-7198
Phone (207) 783-3574
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 432018999 | Medicaid | ME |
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 |
|---|---|---|---|
| LC2470 | ME | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1214352000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1215475200000",
"number": "1407018153",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11 LISBON ST",
"address_2": "SUITE 105",
"city": "LEWISTON",
"state": "ME",
"postal_code": "042407198",
"telephone_number": "207-783-3574"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11 LISBON ST",
"address_2": "SUITE 105",
"city": "LEWISTON",
"state": "ME",
"postal_code": "042407198",
"telephone_number": "207-783-3574"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YORK-LONGPRE",
"first_name": "TIBBY",
"credential": "LADC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-06-25",
"last_updated": "2008-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "ME",
"license": "LC2470",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "432018999",
"state": "ME"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lewiston, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.