Individual provider Active NPI

Johanne Soucy-Camire, M.ED, BCBA

  • Behavior Analyst
  • Old Orchard Beach, ME
National Provider Identifier
1497984728
Registry record updated Jul 8, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-09-5152 Issued in ME
Practice address
15 Macintosh LN
Old Orchard Beach, ME 04064-1477
Phone
(207) 937-2103
NPI assigned
Jul 8, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 1-09-5152 ME Primary

Addresses

Primary practice location

15 Macintosh LN
Old Orchard Beach, ME 04064-1477

Mailing address

15 Macintosh LN
Old Orchard Beach, ME 04064-1477
Phone (207) 937-2103

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Education

NPI Registry JSON

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

{
    "created_epoch": "1247011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1247011200000",
    "number": "1497984728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 MACINTOSH LN",
            "city": "OLD ORCHARD BEACH",
            "state": "ME",
            "postal_code": "040641477",
            "telephone_number": "207-937-2103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 MACINTOSH LN",
            "city": "OLD ORCHARD BEACH",
            "state": "ME",
            "postal_code": "040641477",
            "telephone_number": "207-937-2103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOUCY-CAMIRE",
        "first_name": "JOHANNE",
        "name_prefix": "Mrs.",
        "credential": "M.ED, BCBA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-07-08",
        "last_updated": "2009-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "ME",
            "license": "1-09-5152",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Old Orchard Beach, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2009; 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.