Individual provider Active NPI

Grace O Fosler, LCPC-C

  • Professional Counselor
  • Portland, ME
National Provider Identifier
1710654256
Registry record updated Apr 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
XL6270 Issued in ME
Practice address
63 Preble St
Portland, ME 04101-3014
Phone
(207) 874-2141
Fax
(207) 874-2164
NPI assigned
Aug 24, 2021
Last updated
Apr 8, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X XL6270 ME Primary

Addresses

Primary practice location

63 Preble St
Portland, ME 04101-3014

Mailing address

180 Park Ave
Portland, ME 04102-2957
Phone (207) 874-2141

Other practice location 1

234 Oxford St
Portland, ME 04101-3029
Phone (207) 874-2141

Other practice location 2

934 Congress St
Portland, ME 04102-3032
Phone (207) 874-2141

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250110002105 ME Practitioner - Mental Health Counselor 8921536467 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Portland Community Health CenterGroup PAC ID 5395998017, 37 clinicians

Practice addresses (Care Compare)

63 Preble St
Portland, ME 04101-3014
Phone (207) 874-2141

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
XL6270MEMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Portland Community Health Center CurrentSince Nov 11, 2024 Accepting new patients
Portland Community Health Center Current Accepting new patients
Portland Community Health Center CurrentSince Nov 11, 2024 Accepting new patients

Locations

180 Park Ave
Portland, ME 04102
Phone (207) 772-3703

180 Park Ave
Ste 1
Portland, ME 04102
Phone (207) 828-2101

234 Oxford St
Portland, ME 04101

63 Preble St
Portland, ME 04101
Phone (207) 822-0232

934 Congress St
Portland, ME 04102
Phone (207) 828-2200

Interoperability endpoints

  • Direct secure messaging: grace.fosler.p1@direct.portlandchc.nextgenshare.com

Organizations & group practices 3

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": "1629763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744070400000",
    "number": "1710654256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 PARK AVE",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041022957",
            "telephone_number": "207-874-2141",
            "fax_number": "207-874-2164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "63 PREBLE ST",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041013014",
            "telephone_number": "207-874-2141",
            "fax_number": "207-874-2164"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "234 Oxford St",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "ME",
            "postal_code": "041013029",
            "country_code": "US",
            "telephone_number": "207-874-2141",
            "fax_number": "207-874-2164",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "934 Congress St",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "ME",
            "postal_code": "041023032",
            "country_code": "US",
            "telephone_number": "207-874-2141",
            "fax_number": "207-874-2164",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FOSLER",
        "first_name": "GRACE",
        "middle_name": "O",
        "credential": "LCPC-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-24",
        "last_updated": "2025-04-08",
        "certification_date": "2025-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "ME",
            "license": "XL6270",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, ME

Sources for this page

Verify at the official NPI Registry.