Michael Lawrence Gervais, LCPC-CONDITIONAL

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

CC3046 Issued in ME

Practice address

66 Stone St
Augusta, ME 04330-5227

Phone

(207) 626-3455

Fax

(207) 626-3612

NPI assigned

Aug 31, 2006

Sex

Male

Sole proprietor

No

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

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Kennebec Valley Mental Health Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Waterville, ME
  • NPI 1679504864
  NPD (past)

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1508978255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "66 STONE ST",
            "city": "AUGUSTA",
            "state": "ME",
            "postal_code": "043305227",
            "telephone_number": "207-626-3455",
            "fax_number": "207-626-3612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "66 STONE ST",
            "city": "AUGUSTA",
            "state": "ME",
            "postal_code": "043305227",
            "telephone_number": "207-626-3455",
            "fax_number": "207-626-3612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GERVAIS",
        "first_name": "MICHAEL",
        "middle_name": "LAWRENCE",
        "credential": "LCPC-CONDITIONAL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "ME",
            "license": "CC3046",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Awoala George
• Elaina George, LMSW-CC
• William A George, MD
• Karen Gershman, MD
• Benjamin Gervais
• Paul Gervais Gervais, PHD, LCPC, LPC, LMFT
• Glenn D. Gianini, D.O.
• Soleil Mathieu Gibbs
• David Estel Gideon, DO
• Giles Gifford

• Professional Counselor in Augusta, ME
• Providers in Augusta, ME by specialty
• Professional Counselor in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.