Active NPI
Brian Newbury, LCMHC, LCPC
- Professional Counselor
- Bridgton, ME
National Provider Identifier
1649439811
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- CC3601
- Practice address
- 15 Wayside Ave
Bridgton, ME 04009-1231 - Phone
- (207) 647-4404
- Fax
- (207) 647-4170
- NPI assigned
- Jun 3, 2008
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | CC3601 | ME | Primary |
| Mental Health Counselor | 101YM0800X | 822 | NH |
Addresses
Primary practice location
15 Wayside Ave
Bridgton, ME 04009-1231
Mailing address
15 Wayside Ave
Bridgton, ME 04009-1231
Phone (207) 647-4404
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 |
|---|---|---|---|
| CC3601 | ME | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nfi North, Inc | Past | Accepting new patients | |
| Nfi North, Inc | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Emotionally Disturbed Childrens' Residential Treatment Facility
- Bridgton, ME
- NPI 1134295405
-
- Case Management Agency
- Bridgton, ME
- NPI 1730240896
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1212451200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1294358400000",
"number": "1649439811",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15 WAYSIDE AVE",
"city": "BRIDGTON",
"state": "ME",
"postal_code": "040091231",
"telephone_number": "207-647-4404",
"fax_number": "207-647-4170"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15 WAYSIDE AVE",
"city": "BRIDGTON",
"state": "ME",
"postal_code": "040091231",
"telephone_number": "207-647-4404",
"fax_number": "207-647-4170"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NEWBURY",
"first_name": "BRIAN",
"name_prefix": "Mr.",
"credential": "LCMHC, LCPC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-06-03",
"last_updated": "2011-01-07",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "ME",
"license": "CC3601",
"primary": true
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NH",
"license": "822",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bridgton, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.