Individual provider Active NPI

Laura Nancy Vaillancourt, OTR/L

  • Pediatric Occupational Therapist
  • Lewiston, ME
National Provider Identifier
1770169732
Registry record updated Mar 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
OT3949 Issued in ME
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

Updated by the provider on Mar 21, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

LicenseStateTypeSpecialty
OT3949MEMDPediatric Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Bright Start Therapy, Inc. Pediatrics CurrentSince Mar 28, 2021 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.

Verify at the official NPI Registry.