NPIMap

Organization Active NPI

Umbrella Mental Health Services, PA

  • Mental Health Counselor
  • Damariscotta, ME
National Provider Identifier
1700996063
Registry record updated Mar 13, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
486719 Issued in ME
Legal business name
UMBRELLA MENTAL HEALTH SERVICES, PA
Practice address
73 Biscay Rd
Damariscotta, ME 04543-4614
Phone
(207) 563-3022
Fax
(207) 563-3061
NPI assigned
Aug 30, 2006
Last updated
Mar 13, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2009

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

Authorized official

Name
Mrs. Marjorie Elaine Averill, LCSWNPI 1063503522
Title
President/Owner
Phone
(207) 563-3022

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Child & Adolescent Psychiatric/Mental Health Clinical Nurse Specialist 364SP0807X 486719 ME
Adult Psychiatric/Mental Health Clinical Nurse Specialist 364SP0809X 486719 ME
Mental Health Counselor 101YM0800X 486719 ME Primary

Addresses

Primary practice location

73 Biscay Rd
Damariscotta, ME 04543-4614

Mailing address

PO Box 157
Nobleboro, ME 04555-0157
Phone (207) 563-3022

Other identifiers 2

IdentifierTypeStateIssuer
432269200MedicaidME
9187290OtherMEAETNA

National Provider Directory

National Provider Directory

Locations

66 Chapman St
Ste E
Damariscotta, ME 04543
Phone (207) 563-3022

73 Biscay Rd
Damariscotta, ME 04543
Phone (207) 557-3831

Practitioners & affiliated clinicians

Practitioners 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1236902400000",
    "number": "1700996063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 157",
            "city": "NOBLEBORO",
            "state": "ME",
            "postal_code": "045550157",
            "telephone_number": "207-563-3022",
            "fax_number": "207-563-3061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "73 BISCAY RD",
            "city": "DAMARISCOTTA",
            "state": "ME",
            "postal_code": "045434614",
            "telephone_number": "207-563-3022",
            "fax_number": "207-563-3061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UMBRELLA MENTAL HEALTH SERVICES, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-30",
        "last_updated": "2009-03-13",
        "status": "A",
        "authorized_official_last_name": "AVERILL",
        "authorized_official_first_name": "MARJORIE",
        "authorized_official_middle_name": "ELAINE",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "207-563-3022",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "364SP0807X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health, Child & Adolescent",
            "state": "ME",
            "license": "486719",
            "primary": false
        },
        {
            "code": "364SP0809X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health, Adult",
            "state": "ME",
            "license": "486719",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "ME",
            "license": "486719",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "432269200",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "9187290",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Damariscotta, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2009; 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.