Jennifer L Pelletier, LSW

Primary specialty

CounselorTaxonomy code 101Y00000X

License

CC4825 Issued in ME

Practice address

9 Hillcrest Ave
Randolph, ME 04346-5131

Phone

(207) 582-9206

Fax

(207) 582-9652

NPI assigned

Apr 12, 2007

Last updated

May 16, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Spurwink Services Incorporated

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Portland, ME
  • NPI 1316945090
  NPD (past)
• Spurwink Services Incorporated

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Portland, ME
  • NPI 1760507297
  NPD (past)

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

{
    "created_epoch": "1176336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557964800000",
    "number": "1437373313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "899 RIVERSIDE ST",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041031070",
            "telephone_number": "207-871-1200",
            "fax_number": "207-871-1232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 HILLCREST AVE",
            "city": "RANDOLPH",
            "state": "ME",
            "postal_code": "043465131",
            "telephone_number": "207-582-9206",
            "fax_number": "207-582-9652"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PELLETIER",
        "first_name": "JENNIFER",
        "middle_name": "L",
        "credential": "LSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-12",
        "last_updated": "2019-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "ME",
            "license": "CC4825",
            "primary": true
        },
        {
            "code": "171W00000X",
            "taxonomy_group": "",
            "desc": "Contractor",
            "state": "ME",
            "license": "LS6727",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paula P Lindsey, LSW-CONDITIONAL
• Rebecca A Martin, LCPC-C
• Jenny L McGraw, LSWC
• Carla Jane Mowatt, LMSW-CC
• Rebecca Donaldson Patkus
• Paula J Rowe, LSW
• Bonny Lee Saxon, BA, LMT
• Roy E Siegfriedt, LCPC
• Jaynelle Rae Smith, LSW
• Where Healing Begins PLLC

• Counselor in Randolph, ME
• Providers in Randolph, ME by specialty
• Counselor in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2019; 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.