Individual provider Active NPI

Rachel Wells, LCPC-C, MT-BC

  • Mental Health Counselor
  • Kennebunk, ME
National Provider Identifier
1629399688
Registry record updated Apr 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
XL4818 Issued in ME
Practice address
2 Storer St Ste 403B
Kennebunk, ME 04043-6885
Phone
(207) 370-7376
NPI assigned
Jun 14, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 13, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X
Mental Health Counselor 101YM0800X XL4818 ME Primary

Addresses

Primary practice location

2 Storer St Ste 403B
Kennebunk, ME 04043-6885

Mailing address

62 Portland Rd Ste 50
Kennebunk, ME 04043-6650
Phone (207) 370-7376

Other practice location 1

62 Portland Rd Ste 50
Kennebunk, ME 04043-6650
Phone (207) 370-7376

Other practice location 2

1 Fenn St
Adminstrative Offices
Pittsfield, MA 01201-6278
Phone (413) 629-1251

Other practice location 3

2 Christensen Ln
Kennebunk, ME 04043-7759
Phone (207) 370-7376

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
XL4818MEMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Headwaters Wellness, LLC Mental Health CurrentSince Apr 17, 2022 Accepting new patients

Locations

2 Storer St
Ste 403B
Kennebunk, ME 04043
Phone (207) 370-7376

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": "1276473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649808000000",
    "number": "1629399688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "62 PORTLAND RD STE 50",
            "city": "KENNEBUNK",
            "state": "ME",
            "postal_code": "040436650",
            "telephone_number": "207-370-7376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 STORER ST STE 403B",
            "city": "KENNEBUNK",
            "state": "ME",
            "postal_code": "040436885",
            "telephone_number": "207-370-7376"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "62 Portland Rd Ste 50",
            "address_purpose": "LOCATION",
            "city": "Kennebunk",
            "state": "ME",
            "postal_code": "040436650",
            "country_code": "US",
            "telephone_number": "207-370-7376",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1 Fenn St",
            "address_2": "ADMINSTRATIVE OFFICES",
            "address_purpose": "LOCATION",
            "city": "Pittsfield",
            "state": "MA",
            "postal_code": "012016278",
            "country_code": "US",
            "telephone_number": "413-629-1251",
            "fax_number": "413-448-2198",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2 Christensen Ln",
            "address_purpose": "LOCATION",
            "city": "Kennebunk",
            "state": "ME",
            "postal_code": "040437759",
            "country_code": "US",
            "telephone_number": "207-370-7376",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WELLS",
        "first_name": "RACHEL",
        "credential": "LCPC-C, MT-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-06-14",
        "last_updated": "2022-04-13",
        "certification_date": "2022-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "ME",
            "license": "XL4818",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kennebunk, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2022; 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.