Maria Beauregard
Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Portland, ME
NPI 1801427893 · NPPES record last updated Jan 29, 2020
Key facts
- NPI
- 1801427893
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Addiction (Substance Use Disorder) Counselor 101YA0400X
- License
- CAC4606 (ME)
- Practice address
- 66 State St
Portland, ME 04101-3751 - Phone
- (207) 837-8414
- NPI assigned
- Jan 29, 2020
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CAC4606 | ME | MD | Addiction (Substance Use Disorder) Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | CAC4606 | ME | Yes |
Addresses
Primary practice location
66 State St
Portland, ME 04101-3751
Mailing address
66 State St
Portland, ME 04101-3751
NPI Registry JSON
{
"created_epoch": "1580256000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1580256000000",
"number": "1801427893",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "66 STATE ST",
"city": "PORTLAND",
"state": "ME",
"postal_code": "041013751"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "66 STATE ST",
"city": "PORTLAND",
"state": "ME",
"postal_code": "041013751",
"telephone_number": "207-837-8414"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BEAUREGARD",
"first_name": "MARIA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-01-29",
"last_updated": "2020-01-29",
"certification_date": "2020-01-29",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "ME",
"license": "CAC4606",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Portland, ME
- Jennifer L Beaule
- Danielle R Beaulieu
- Sara Beaulieu
- Zachary Robert Beaulieu
- Danielle Beaumont
- Meredith Beauregard
- Eric A Beaver
- Sophia Catherine Bechek
- Colin Joseph Bechtel
- Lloyd F Beckett
All providers in Portland, ME · Addiction (Substance Use Disorder) Counselor in Maine
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 29, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.