Individual provider Active NPI

Lauren S Manchester, LADC

  • Addiction (Substance Use Disorder) Counselor
  • South Portland, ME
National Provider Identifier
1639269384
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
LC2767 Issued in ME
Practice address
650 Main St
Suite 103
South Portland, ME 04106-5448
Phone
(207) 774-4564
Fax
(207) 774-0006
NPI assigned
Oct 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X LC2767 ME Primary

Addresses

Primary practice location

650 Main St
Suite 103
South Portland, ME 04106-5448

Mailing address

650 Main St
Suite 103
South Portland, ME 04106-5448
Phone (207) 774-4564

Other names 1

  • Mrs. Laurie S Manchester Other name

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
LC2767MEMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Food Addiction Chemical Dependency Consultants LLC Addiction (Substance Use Disorder) Past Accepting new patients

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": "1160697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1639269384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "650 MAIN ST",
            "address_2": "SUITE 103",
            "city": "SOUTH PORTLAND",
            "state": "ME",
            "postal_code": "041065448",
            "telephone_number": "207-774-4564",
            "fax_number": "207-774-0006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 MAIN ST",
            "address_2": "SUITE 103",
            "city": "SOUTH PORTLAND",
            "state": "ME",
            "postal_code": "041065448",
            "telephone_number": "207-774-4564",
            "fax_number": "207-774-0006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANCHESTER",
        "first_name": "LAUREN",
        "middle_name": "S",
        "name_prefix": "Mrs.",
        "credential": "LADC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "ME",
            "license": "LC2767",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LAURIE",
            "last_name": "MANCHESTER",
            "middle_name": "S",
            "prefix": "MRS.",
            "credential": "LADC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in South Portland, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.