Individual provider Active NPI

Tina Lynne Nightingale, LCPCCC

  • Mental Health Counselor
  • Saco, ME
National Provider Identifier
1467820027
Registry record updated Sep 11, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
XL4529 Issued in ME
Practice address
31 Trailside Cir
Saco, ME 04072-1663
Phone
(207) 949-0970
NPI assigned
Sep 11, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X XL4529 ME Primary

Addresses

Primary practice location

31 Trailside Cir
Saco, ME 04072-1663

Mailing address

31 Trailside Cir
Saco, ME 04072-1663
Phone (207) 949-0970

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240125000269 ME Practitioner - Mental Health Counselor 6800249913 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Spurwink Services IncorporatedGroup PAC ID 7810026945, 87 clinicians

Practice addresses (Care Compare)

180 Main St
Biddeford, ME 04005-2410
Phone (207) 283-0587

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
XL4529MEMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Spurwink Services Incorporated CurrentSince Jan 1, 2024 Accepting new patients
Spurwink Services Incorporated Past Accepting new patients

Locations

180 Main St
Biddeford, ME 04005
Phone (207) 283-0587

901 Washington Ave
Ste 100
Portland, ME 04103
Phone 20787112112145

9 Hillcrest Ave
Randolph, ME 04346
Phone (207) 582-9205

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1441929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1441929600000",
    "number": "1467820027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31 TRAILSIDE CIR",
            "city": "SACO",
            "state": "ME",
            "postal_code": "040721663",
            "telephone_number": "207-949-0970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31 TRAILSIDE CIR",
            "city": "SACO",
            "state": "ME",
            "postal_code": "040721663",
            "telephone_number": "207-949-0970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIGHTINGALE",
        "first_name": "TINA",
        "middle_name": "LYNNE",
        "name_prefix": "Mrs.",
        "credential": "LCPCCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-09-11",
        "last_updated": "2015-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "ME",
            "license": "XL4529",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saco, ME

Sources for this page

Verify at the official NPI Registry.