Active NPI
Kelly Katherine Bumiller, LCPC
- Mental Health Counselor
- Brunswick, ME
National Provider Identifier
1609336544
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- CC5235
- Practice address
- 6 Cumberland St
Brunswick, ME 04011-1904 - Phone
- (207) 798-9281
- NPI assigned
- Mar 25, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | CC5235 | ME | Primary |
Addresses
Primary practice location
6 Cumberland St
Brunswick, ME 04011-1904
Mailing address
6 Cumberland St
Brunswick, ME 04011-1904
Phone (207) 798-9281
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
| License | State | Type | Specialty |
|---|---|---|---|
| CC5235 | ME | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1553472000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1565222400000",
"number": "1609336544",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6 CUMBERLAND ST",
"city": "BRUNSWICK",
"state": "ME",
"postal_code": "040111904",
"telephone_number": "207-798-9281"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6 CUMBERLAND ST",
"city": "BRUNSWICK",
"state": "ME",
"postal_code": "040111904",
"telephone_number": "207-798-9281"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BUMILLER",
"first_name": "KELLY",
"middle_name": "KATHERINE",
"name_prefix": "Ms.",
"credential": "LCPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-03-25",
"last_updated": "2019-08-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "ME",
"license": "CC5235",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brunswick, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.