Gwendolyn Shatto, LCPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

XL4869 Issued in ME

Practice address

72 Front St Ste 9
Bath, ME 04530-2657

Phone

(207) 208-9193

NPI assigned

Jun 9, 2017

Last updated

Sep 23, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ME

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Cornerstone Behavioral Healthcare LLCGroup PAC ID 7214097740, 29 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Cornerstone Behavioral Healthcare, LLC

  • Community/Behavioral Health Agency
  • Bangor, ME
  • NPI 1215102850
  Medicare reassignment Care Compare group NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1496966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632355200000",
    "number": "1801325147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "213 RIVER RD",
            "city": "WOOLWICH",
            "state": "ME",
            "postal_code": "045794203",
            "telephone_number": "207-208-9166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "72 FRONT ST STE 9",
            "city": "BATH",
            "state": "ME",
            "postal_code": "045302657",
            "telephone_number": "207-208-9193"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHATTO",
        "first_name": "GWENDOLYN",
        "credential": "LCPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-06-09",
        "last_updated": "2021-09-23",
        "certification_date": "2021-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "ME",
            "license": "XL4869",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brittany Rothwell, BCBA
• Robyn B Rousseau, DMD
• Erica Jean Roy, NP-C
• Ariana Elizabeth Russo, OT
• Brian Schaab, CF
• Alice Shea, M.D.
• Robert Lester Sheehan, LCSW
• Victoria Simpson
• Karin Margot Sinclair
• Kimberly Marion Sirois, PT

• Mental Health Counselor in Bath, ME
• Providers in Bath, ME by specialty
• Mental Health Counselor in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.