Active NPI
Marie Mitchell, LCPC, CADC
- Counselor
- Indian Island, ME
National Provider Identifier
1750450896
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- CAC3261
- Practice address
- 23 Wabanaki Way
Indian Island, ME 04468-1252 - Phone
- (207) 817-7400
- Fax
- (207) 827-5022
- NPI assigned
- Nov 6, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | CAC3261 | ME | Primary |
Addresses
Primary practice location
23 Wabanaki Way
Indian Island, ME 04468-1252
Mailing address
23 Wabanaki Way
Indian Island, ME 04468-1252
Phone (207) 817-7400
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CAC3261 | ME | MD | Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162771200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1750450896",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "23 WABANAKI WAY",
"city": "INDIAN ISLAND",
"state": "ME",
"postal_code": "044681252",
"telephone_number": "207-817-7400",
"fax_number": "207-827-5022"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "23 WABANAKI WAY",
"city": "INDIAN ISLAND",
"state": "ME",
"postal_code": "044681252",
"telephone_number": "207-817-7400",
"fax_number": "207-827-5022"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MITCHELL",
"first_name": "MARIE",
"credential": "LCPC, CADC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-11-06",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "ME",
"license": "CAC3261",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Indian Island, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.