Christopher Ray Van Doren, LCPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

CC3069 Issued in ME

Practice address

11 Brick Hill Rd
Windham, ME 04062-3359

Phone

(207) 831-9480

NPI assigned

May 8, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1178582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280707200000",
    "number": "1700099595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "95 PARKER ST",
            "address_2": "C/O HOSA",
            "city": "NEWBURYPORT",
            "state": "MA",
            "postal_code": "019504033",
            "telephone_number": "978-225-2250",
            "fax_number": "978-225-2251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 BRICK HILL RD",
            "city": "WINDHAM",
            "state": "ME",
            "postal_code": "040623359",
            "telephone_number": "207-831-9480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN DOREN",
        "first_name": "CHRISTOPHER",
        "middle_name": "RAY",
        "credential": "LCPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-08",
        "last_updated": "2010-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "ME",
            "license": "CC3069",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "431538599",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Windham, ME
• Providers in Windham, ME by specialty
• Mental Health Counselor in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2010; 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.