NPIMap

Organization Active NPI

Providence Service Corporation of Maine

  • Community/Behavioral Health Agency
  • Brunswick, ME
National Provider Identifier
1629338769
Registry record updated May 23, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
392123 Issued in ME
Legal business name
PROVIDENCE SERVICE CORPORATION OF MAINE
Practice address
14 Maine St
Suite 202, Box 50
Brunswick, ME 04011-2049
Phone
(207) 373-0620
NPI assigned
May 23, 2012
Last updated
May 23, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 23, 2012

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

Authorized official

Name
William Beattie, LCSWNPI 1972838019
Title
State Executive Director
Phone
(207) 373-0620

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 392123 ME Primary

Addresses

Primary practice location

14 Maine St
Suite 202, Box 50
Brunswick, ME 04011-2049

Mailing address

14 Maine St
Suite 202, Box 50
Brunswick, ME 04011-2049
Phone (207) 373-0620

Other identifiers 1

IdentifierTypeStateIssuer
191700000MedicaidME

National Provider Directory

National Provider Directory
Tax ID family
Pathways of Maine Inc10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

Organizations that report the same tax identification number in the National Provider Directory.

Locations

14 Maine St
Ste 202
Brunswick, ME 04011
Phone (207) 332-8567

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1337731200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1337731200000",
    "number": "1629338769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 MAINE ST",
            "address_2": "SUITE 202, BOX 50",
            "city": "BRUNSWICK",
            "state": "ME",
            "postal_code": "040112049",
            "telephone_number": "207-373-0620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14 MAINE ST",
            "address_2": "SUITE 202, BOX 50",
            "city": "BRUNSWICK",
            "state": "ME",
            "postal_code": "040112049",
            "telephone_number": "207-373-0620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVIDENCE SERVICE CORPORATION OF MAINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-23",
        "last_updated": "2012-05-23",
        "status": "A",
        "authorized_official_last_name": "BEATTIE",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_title_or_position": "STATE EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "207-373-0620",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "ME",
            "license": "392123",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "191700000",
            "state": "ME"
        }
    ],
    "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 May 23, 2012; 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.