Individual provider Active NPI

Tracie Lynn Giambra-Vye, LCPC-C

  • Professional Counselor
  • Lewiston, ME
National Provider Identifier
1548086705
Registry record updated Dec 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
XL7837 Issued in ME
Practice address
179 Lisbon St Ste 201
Lewiston, ME 04240-7248
Phone
(207) 405-7501
Fax
(207) 782-9011
NPI assigned
Dec 3, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 3, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X XL7837 ME Primary

Addresses

Primary practice location

179 Lisbon St Ste 201
Lewiston, ME 04240-7248

Mailing address

179 Lisbon St Ste 201
Lewiston, ME 04240-7248
Phone (207) 405-7501

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

State licenses

LicenseStateTypeSpecialty
XL7837MEMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
The Canvas of Life Counseling LLC Professional CurrentSince Dec 8, 2024 Accepting new patients

Locations

179 Lisbon St
Ste 201
Lewiston, ME 04240
Phone (207) 241-9332

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1733184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733184000000",
    "number": "1548086705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "179 LISBON ST STE 201",
            "city": "LEWISTON",
            "state": "ME",
            "postal_code": "042407248",
            "telephone_number": "207-405-7501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "179 LISBON ST STE 201",
            "city": "LEWISTON",
            "state": "ME",
            "postal_code": "042407248",
            "telephone_number": "207-405-7501",
            "fax_number": "207-782-9011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIAMBRA-VYE",
        "first_name": "TRACIE",
        "middle_name": "LYNN",
        "credential": "LCPC-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-12-03",
        "last_updated": "2024-12-03",
        "certification_date": "2024-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "ME",
            "license": "XL7837",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lewiston, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 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.