Active NPI
Jackie L Buotte, LCPCC
- Professional Counselor
- Bucksport, ME
National Provider Identifier
1780989608
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- XL3529
- Practice address
- 66 Bridge St
Jewett School
Bucksport, ME 04416-4087 - Phone
- (207) 469-2755
- NPI assigned
- Jan 25, 2011
- Last updated
- Apr 4, 2017
- 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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | XL3529 | ME | Primary |
Addresses
Primary practice location
66 Bridge St
Jewett School
Bucksport, ME 04416-4087
Mailing address
PO Box 1729
Jewett School
Bucksport, ME 04416-1729
Phone (207) 469-2755
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 |
|---|---|---|---|
| XL3529 | ME | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1295913600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1491264000000",
"number": "1780989608",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1729",
"address_2": "JEWETT SCHOOL",
"city": "BUCKSPORT",
"state": "ME",
"postal_code": "044161729",
"telephone_number": "207-469-2755"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "66 BRIDGE ST",
"address_2": "JEWETT SCHOOL",
"city": "BUCKSPORT",
"state": "ME",
"postal_code": "044164087",
"telephone_number": "207-469-2755"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BUOTTE",
"first_name": "JACKIE",
"middle_name": "L",
"credential": "LCPCC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-01-25",
"last_updated": "2017-04-04",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "ME",
"license": "XL3529",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bucksport, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.