Summit Achievement of Stow

Primary specialty

Children's Substance Abuse Rehabilitation FacilityTaxonomy code 3245S0500X

License

216716 Issued in ME

Legal business name

SUMMIT ACHIEVEMENT OF STOW

Doing business as

Summit Traverse

Practice address

69 Deer Hill Rd
Stow, ME 04037-3100

Phone

(207) 697-2020

Fax

(207) 697-2021

NPI assigned

Jul 1, 2008

Last updated

Jun 5, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Nicholas ErnstNPI 1023353224

Title

Ceo, Clinical Director

Phone

(207) 697-2020

Specialties & licenses 2

Addresses

Other names 1

• Summit Traverse Doing business as

Tax ID family

Summit Achievement of Stow Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Summit Achievement of Stow, Inc.

  dba Summit Achievement

  • Adolescent and Children Mental Health Clinic/Center
  • Stow, ME
  • NPI 1801648803
  NPD tax ID

Locations

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Summit Achievement of Stow, Inc.

  dba Summit Achievement

  • Adolescent and Children Mental Health Clinic/Center
  • Stow, ME
  • NPI 1801648803
  NPPES parent name

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Nicholas Ernst, LCSW

  • Clinical Social Worker
  • Stow, ME
  • NPI 1023353224
  NPD Authorized official
• Caitlyn Eileen Cook, LCMHC, LCPC, LCAT

  • Mental Health Counselor
  • Center Ossipee, NH
  • NPI 1750945945
  NPD (past)
• Kathryn E Peters, LICSW

  • Clinical Social Worker
  • Guildhall, VT
  • NPI 1912236787
  NPD (past)

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

{
    "created_epoch": "1214870400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717545600000",
    "number": "1497917371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "69 DEER HILL RD",
            "city": "STOW",
            "state": "ME",
            "postal_code": "040373100",
            "telephone_number": "207-697-2020",
            "fax_number": "207-697-2021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "69 DEER HILL RD",
            "city": "STOW",
            "state": "ME",
            "postal_code": "040373100",
            "telephone_number": "207-697-2020",
            "fax_number": "207-697-2021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMMIT ACHIEVEMENT OF STOW",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-01",
        "last_updated": "2024-06-05",
        "certification_date": "2024-06-05",
        "status": "A",
        "authorized_official_last_name": "ERNST",
        "authorized_official_first_name": "NICHOLAS",
        "authorized_official_title_or_position": "CEO, CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "207-697-2020"
    },
    "taxonomies": [
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "ME",
            "license": "216716",
            "primary": false
        },
        {
            "code": "3245S0500X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children",
            "state": "ME",
            "license": "216716",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Summit Traverse",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Nicholas Ernst, LCSW
• Lynn Ouellette
• Summit Achievement of Stow, Inc. (Summit Achievement)

• Children's Substance Abuse Rehabilitation Facility in Stow, ME
• Providers in Stow, ME by specialty
• Children's Substance Abuse Rehabilitation Facility in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2024; 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.