Active NPI
Daniel N Creek, LCPC-C
- Professional Counselor
- Portland, ME
National Provider Identifier
1780095349
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- XL4296
- Practice address
- 611 Brighton Ave
Portland, ME 04102-2322 - Phone
- (207) 332-5792
- NPI assigned
- May 16, 2014
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | XL4296 | ME | Primary |
Addresses
Primary practice location
611 Brighton Ave
Portland, ME 04102-2322
Mailing address
47 Westminster Ave
Portland, ME 04103-2430
Phone (207) 332-5792
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Mar 9, 2024 through Mar 9, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| XL4296 | ME | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1400198400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1631491200000",
"number": "1780095349",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "47 WESTMINSTER AVE",
"city": "PORTLAND",
"state": "ME",
"postal_code": "041032430",
"telephone_number": "207-332-5792"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "611 BRIGHTON AVE",
"city": "PORTLAND",
"state": "ME",
"postal_code": "041022322",
"telephone_number": "207-332-5792"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CREEK",
"first_name": "DANIEL",
"middle_name": "N",
"credential": "LCPC-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-05-16",
"last_updated": "2021-09-13",
"certification_date": "2021-09-13",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "ME",
"license": "XL4296",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Portland, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.