NPIMap

Organization Active NPI

Kennebec Valley Mental Health Center

Doing business as Kennebec Behavioral Health

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Waterville, ME
National Provider Identifier
1679504864
Registry record updated Jan 24, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
License
222762 Issued in ME
Legal business name
KENNEBEC VALLEY MENTAL HEALTH CENTER
Doing business as
Kennebec Behavioral Health
Practice address
67 Eustis Pkwy
Waterville, ME 04901-5173
Phone
(207) 873-2136
Fax
(207) 872-4522
NPI assigned
Jul 5, 2006
Last updated
Jan 24, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2008

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

Authorized official

Name
Thomas McAdam
Title
Chief Executive Officer
Phone
(207) 873-2136

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X 222762 ME Primary

Addresses

Primary practice location

67 Eustis Pkwy
Waterville, ME 04901-5173

Mailing address

67 Eustis Pkwy
Waterville, ME 04901-5173
Phone (207) 873-2136

Other names 1

  • Kennebec Behavioral Health Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040127000419 ME Part B Supplier - Clinic/Group Practice 7113829383 Receives reassigned benefits from 100 practitioners
Practice locations: Augusta, ME; Winthrop, ME; Waterville, ME; Skowhegan, ME; Farmington, ME

National Provider Directory

National Provider Directory

Locations

10 Caldwell Rd
Augusta, ME 04330
Phone (207) 626-3448

37 Stone St
Augusta, ME 04330
Phone (207) 626-3455

66 Stone St
Augusta, ME 04330
Phone (207) 626-3455

115 Mt Blue Cir
Farmington, ME 04938
Phone (207) 778-9664

116 Narrow Gauge Sq
Ste 101
Farmington, ME 04938
Phone (207) 578-6219

16 Concourse W
#2
Waterville, ME 04901
Phone (207) 680-4635

26 College Ave
Waterville, ME 04901
Phone (207) 877-0038

736 Old Lewiston Rd
Winthrop, ME 04364
Phone 2073778122 ext. 1407

Practitioners & affiliated clinicians

Practitioners 206

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.

View all 206

NPI Registry JSON

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

{
    "created_epoch": "1152057600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1201132800000",
    "number": "1679504864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "67 EUSTIS PKWY",
            "city": "WATERVILLE",
            "state": "ME",
            "postal_code": "049015173",
            "telephone_number": "207-873-2136",
            "fax_number": "207-872-4522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "67 EUSTIS PKWY",
            "city": "WATERVILLE",
            "state": "ME",
            "postal_code": "049015173",
            "telephone_number": "207-873-2136",
            "fax_number": "207-872-4522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENNEBEC VALLEY MENTAL HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-05",
        "last_updated": "2008-01-24",
        "status": "A",
        "authorized_official_last_name": "MCADAM",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "207-873-2136"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "ME",
            "license": "222762",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kennebec Behavioral Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Waterville, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2008; 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.