Individual provider Active NPI

Mary-Ellen Ostherr, MA LADC CCS

  • Addiction (Substance Use Disorder) Counselor
  • Rockland, ME
National Provider Identifier
1407936669
Registry record updated Jun 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
LC3421 Issued in ME
Practice address
17 Masonic Street
Rockland, ME 04841
Phone
(207) 841-6775
Fax
(207) 236-8073
NPI assigned
Oct 16, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2008

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 LC3421 ME Primary

Addresses

Primary practice location

17 Masonic Street
Rockland, ME 04841

Mailing address

310 Hosmer Pond Rd
Camden, ME 04843-4053
Phone (207) 841-6775

Other identifiers 1

IdentifierTypeStateIssuer
104000000MedicaidME

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
LC3421MEMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1160956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213142400000",
    "number": "1407936669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 HOSMER POND RD",
            "city": "CAMDEN",
            "state": "ME",
            "postal_code": "048434053",
            "telephone_number": "207-841-6775",
            "fax_number": "207-236-8073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 MASONIC STREET",
            "city": "ROCKLAND",
            "state": "ME",
            "postal_code": "04841",
            "telephone_number": "207-841-6775",
            "fax_number": "207-236-8073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OSTHERR",
        "first_name": "MARY-ELLEN",
        "credential": "MA  LADC  CCS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-16",
        "last_updated": "2008-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "ME",
            "license": "LC3421",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104000000",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockland, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 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.

Verify at the official NPI Registry.