Laurie Ellen Mouradian

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

XL7159 Issued in ME

Practice address

77 Court St
Bangor, ME 04401-4723

Phone

(207) 941-0879

Fax

(207) 941-0880

NPI assigned

Jul 21, 2023

Sex

Female

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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 and National Provider Directory roles.

• Behavioral Health Center

  • Clinical Social Worker
  • Bangor, ME
  • NPI 1346333838
  NPD
• Knada, PA

  • Clinical Social Worker
  • Bangor, ME
  • NPI 1841795127
  NPD

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

{
    "created_epoch": "1689897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689897600000",
    "number": "1811677131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "77 COURT ST",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044014723",
            "telephone_number": "207-941-0879",
            "fax_number": "207-941-0880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 COURT ST",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044014723",
            "telephone_number": "207-941-0879",
            "fax_number": "207-941-0880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOURADIAN",
        "first_name": "LAURIE",
        "middle_name": "ELLEN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-21",
        "last_updated": "2023-07-21",
        "certification_date": "2023-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "ME",
            "license": "XL7159",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Raymond Mortellitti, LCSW
• Moshe Myerowitz DC PA
• Terry Mosher, FNP
• Alfreda Mouland, FNP
• Paul Rush Moulton, M.D.
• Polly Moutevelis-Burgess, LCPC, LMFT
• Mayur Movalia, M.D.
• Moving Forward Mental Health Services
• Amy J Movius, MD
• Picabo-Siera M Mower, LCSW

• Mental Health Counselor in Bangor, ME
• Providers in Bangor, 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 Jul 21, 2023; 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.