Jennifer A Blanchette, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

1372 Issued in ME

Practice address

1321 Washington Ave
Portland, ME 04103-3654

Phone

(207) 749-2343

NPI assigned

Mar 7, 2013

Last updated

May 25, 2015By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Previously, effective Aug 14, 2022 through Aug 14, 2026

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• New Life Counseling, LLC

  • Clinical Psychologist
  • Portland, ME
  • NPI 1558775197
  Authorized official Same address or phone

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

{
    "created_epoch": "1362614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1432512000000",
    "number": "1497096051",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1321 WASHINGTON AVE",
            "address_2": "SUITE 304",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041033654",
            "telephone_number": "207-749-2343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1321 WASHINGTON AVE",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041033654",
            "telephone_number": "207-749-2343"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLANCHETTE",
        "first_name": "JENNIFER",
        "middle_name": "A",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-03-07",
        "last_updated": "2015-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "ME",
            "license": "1372",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Victoria Blake
• Paul Blakeslee, MS, RD-AP, LD, CNSC
• Holly Blanchard, LCSW
• Oliver Gimpel Blanchard, PHARMD
• Aaron Blanchette, PSY.D.
• Kimberly M. Blaney, LCPC
• Cheryl L Blank, DO
• Patricia W Blankenship, LCSW
• Hagen Blaszyk, M.D.
• Summerlee Blauvelt, LCPC-CC

• Clinical Psychologist in Portland, ME
• Providers in Portland, ME by specialty
• Clinical Psychologist in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.