Individual provider Active NPI

Joanna Damen Lusk-Libby, APRN-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Waterville, ME
National Provider Identifier
1699393694
Registry record updated Jul 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
CNP201264 Issued in ME
Practice address
67 Eustis Pkwy
Waterville, ME 04901-5173
Phone
(207) 873-2136
NPI assigned
Jul 7, 2020
Last updated
Jul 7, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X CNP201264 ME Primary

Addresses

Primary practice location

67 Eustis Pkwy
Waterville, ME 04901-5173

Mailing address

PO Box 22
South Windham, ME 04082-0022
Phone (410) 440-5848

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200903001424 ME Practitioner - Nurse Practitioner 0749607802 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kennebec Valley Mental Health CenterGroup PAC ID 7113829383, 68 clinicians

Practice addresses (Care Compare)

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

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Kennebec Valley Mental Health Center CurrentSince Aug 10, 2020 Accepting new patients

Locations

11 Caldwell Rd
Augusta, ME 04330
Phone (207) 623-7710

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

5 Commerce Dr
Skowhegan, ME 04976
Phone (207) 474-8311

67 Eustis Pkwy
Waterville, ME 04901
Phone (207) 660-4549

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1594080000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594080000000",
    "number": "1699393694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 22",
            "city": "SOUTH WINDHAM",
            "state": "ME",
            "postal_code": "040820022",
            "telephone_number": "410-440-5848"
        },
        {
            "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"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUSK-LIBBY",
        "first_name": "JOANNA",
        "middle_name": "DAMEN",
        "credential": "APRN-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-07",
        "last_updated": "2020-07-07",
        "certification_date": "2020-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "ME",
            "license": "CNP201264",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterville, ME

Sources for this page

Verify at the official NPI Registry.