Jessica L Packard, LCPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

CC4601 Issued in ME

Practice address

153 Park Row Ste 103
Brunswick, ME 04011-2053

Phone

(207) 504-3587

NPI assigned

Feb 14, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Rise Up LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Brunswick, ME
  • NPI 1811404098
  NPD Authorized official

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

{
    "created_epoch": "1329177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1740553346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "153 PARK ROW STE 103",
            "city": "BRUNSWICK",
            "state": "ME",
            "postal_code": "040112053",
            "telephone_number": "207-504-3587"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "153 PARK ROW STE 103",
            "city": "BRUNSWICK",
            "state": "ME",
            "postal_code": "040112053",
            "telephone_number": "207-504-3587"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "76 Pleasant St",
            "address_purpose": "LOCATION",
            "city": "Brunswick",
            "state": "ME",
            "postal_code": "040112203",
            "country_code": "US",
            "telephone_number": "207-721-0214",
            "fax_number": "207-721-0215",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PACKARD",
        "first_name": "JESSICA",
        "middle_name": "L",
        "credential": "LCPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-02-14",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "ME",
            "license": "XL3914",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "ME",
            "license": "CC4601",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lindy Ost, PT
• Otto John Vnek, DDS, PC
• Jennifer Anthony Roche Ouellette, LCSW
• Patricia Lynn Ouellette, M.D.
• Peggy A Ouellette, FPMH-NP
• Tamzyn Palmer
• Bo Pang, DO
• Paper Crane Acupuncture and Wellness, LLC
• Shawn Paquette, DPT
• Sarah L Keats Pardue, M.S.

• Professional Counselor in Brunswick, ME
• Providers in Brunswick, ME by specialty
• Professional Counselor in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.