Kennebec Counseling Services LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

KENNEBEC COUNSELING SERVICES LLC

Practice address

204 Shore Rd
Fayette, ME 04349-3238

Phone

(207) 489-4675

Fax

(207) 466-8507

NPI assigned

Feb 8, 2024

Last updated

Feb 8, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Emily Stultz, LCSWNPI 1992337737

Title

Owner

Phone

(207) 861-1690

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ME

Enrollment records 1

Locations

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.

• Emily Winter Stultz, LCSW

  • Clinical Social Worker
  • Fayette, ME
  • NPI 1992337737
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1707350400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707350400000",
    "number": "1679337786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 SHORE RD",
            "city": "FAYETTE",
            "state": "ME",
            "postal_code": "043493238",
            "telephone_number": "207-489-4675",
            "fax_number": "207-466-8507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 SHORE RD",
            "city": "FAYETTE",
            "state": "ME",
            "postal_code": "043493238",
            "telephone_number": "207-489-4675",
            "fax_number": "207-466-8507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENNEBEC COUNSELING SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-08",
        "last_updated": "2024-02-08",
        "certification_date": "2024-02-08",
        "status": "A",
        "authorized_official_last_name": "STULTZ",
        "authorized_official_first_name": "EMILY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "207-861-1690",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Fayette School Dept
• Emily Winter Stultz, LCSW

• Community/Behavioral Health Agency in Fayette, ME
• Providers in Fayette, ME by specialty
• Community/Behavioral Health Agency in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.