Michelle Marie Joubert, MA, BC-DMT, CHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

CC4207 Issued in ME

Practice address

110 Main St Ste 1508
Saco, ME 04072-3517

Phone

(207) 200-1445

NPI assigned

Feb 27, 2009

Last updated

Jun 1, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other names 1

• Michelle Marie Gaudreau Former name

Medicare fee-for-service enrollment

Enrolled in ME

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Momentum Mental Health LLC

  dba Ellie Mental Health

  • Mental Health Counselor
  • Falmouth, ME
  • NPI 1033801675
  Medicare reassignment NPD

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

{
    "created_epoch": "1235692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685577600000",
    "number": "1629218847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 DEPOT RD STE 2",
            "city": "FALMOUTH",
            "state": "ME",
            "postal_code": "041051211",
            "telephone_number": "207-835-3616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 MAIN ST STE 1508",
            "city": "SACO",
            "state": "ME",
            "postal_code": "040723517",
            "telephone_number": "207-200-1445"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "50 Depot Rd Ste 2",
            "address_purpose": "LOCATION",
            "city": "Falmouth",
            "state": "ME",
            "postal_code": "041051211",
            "country_code": "US",
            "telephone_number": "207-835-3616",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "12 Colley Brook Dr",
            "address_purpose": "LOCATION",
            "city": "Windham",
            "state": "ME",
            "postal_code": "040624557",
            "country_code": "US",
            "telephone_number": "978-870-6931",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOUBERT",
        "first_name": "MICHELLE",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "MA, BC-DMT, CHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-02-27",
        "last_updated": "2023-06-01",
        "certification_date": "2023-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MA",
            "license": "6905",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "ME",
            "license": "CC4207",
            "primary": true
        },
        {
            "code": "101YS0200X",
            "taxonomy_group": "",
            "desc": "Counselor, School",
            "state": "MA",
            "license": "6905",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHELLE",
            "last_name": "GAUDREAU",
            "middle_name": "MARIE",
            "credential": "LMHC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Mental Health Counselor in Saco, ME
• Providers in Saco, ME by specialty
• Mental Health Counselor in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.