Active NPI
Laura Nancy Vaillancourt, OTR/L
- Pediatric Occupational Therapist
- Lewiston, ME
National Provider Identifier
1770169732
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Occupational Therapist
- License
- OT3949
- Practice address
- 23 Westminster St
Lewiston, ME 04240-3531 - Phone
- (207) 777-7000
- NPI assigned
- Mar 21, 2021
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Pediatric Occupational Therapist | 225XP0200X | OT3949 | ME | Primary |
Addresses
Primary practice location
23 Westminster St
Lewiston, ME 04240-3531
Mailing address
55 West St Unit 1
Freeport, ME 04032-1167
Phone (207) 949-5235
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 |
|---|---|---|---|
| OT3949 | ME | MD | Pediatric Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bright Start Therapy, Inc. | Pediatrics | Current | Accepting new patients |
Locations
23 Westminster St
Lewiston, ME 04240
Phone 2075778442 ext. 20757
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1616284800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1616284800000",
"number": "1770169732",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "55 WEST ST UNIT 1",
"city": "FREEPORT",
"state": "ME",
"postal_code": "040321167",
"telephone_number": "207-949-5235"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "23 WESTMINSTER ST",
"city": "LEWISTON",
"state": "ME",
"postal_code": "042403531",
"telephone_number": "207-777-7000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VAILLANCOURT",
"first_name": "LAURA",
"middle_name": "NANCY",
"credential": "OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-03-21",
"last_updated": "2021-03-21",
"certification_date": "2021-03-21",
"status": "A"
},
"taxonomies": [
{
"code": "225XP0200X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Pediatrics",
"state": "ME",
"license": "OT3949",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Lewiston, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.