Tracy W Bennett, LCPC
Individual provider Active NPI Mental Health Counselor · Portland, ME
NPI 1487869210 · NPPES record last updated Jul 9, 2021
Key facts
- NPI
- 1487869210
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- License
- CC1576 (ME)
- Practice address
- 55 Bell St
Portland, ME 04103-3418 - Phone
- (207) 604-2461
- Fax
- (207) 514-8333
- NPI assigned
- May 14, 2007
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CC1576 | ME | MD | Mental Health Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | CC1576 | ME | Yes |
Addresses
Primary practice location
55 Bell St
Portland, ME 04103-3418
Mailing address
1590 Milton Mills Rd
Acton, ME 04001-5008
Phone (207) 604-2461
Other providers in Portland, ME
- Mary Bennett
- Michael Bennett
- Robert Bennett Jr.
- Shannon M. Bennett
- Theresa L Bennett
- David Arthur Benoit Sr.
- Lynne A Benoit
- Suzanne V Benoit
- Christopher Michael Benson
- Jeffrey Alan Benson
All providers in Portland, ME · Mental Health Counselor in Maine
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 9, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.