Ellen Haney, LCPC
Individual provider Active NPI Mental Health Counselor · Portland, ME
NPI 1831260926 · NPPES record last updated Aug 5, 2009
Key facts
- NPI
- 1831260926
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- License
- CC1537 (ME)
- Practice address
- 17 Bishop St
Portland, ME 04103-2659 - Phone
- (207) 871-1235
- Fax
- (207) 879-6161
- NPI assigned
- Nov 13, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in ME
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240717001284 | ME | Practitioner - Mental Health Counselor | 7315482015 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CC1537 | ME | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Health Affiliates Maine, LLC | Current |
Accepting new patients | |
| Mental Health Specialty Group PA | Mental Health | Current |
Accepting new patients |
| Sweetser | Current |
Accepting new patients |
Locations
306 Rodman Rd
Auburn, ME 04210
Phone (207) 333-3278
329 Bath Rd
Brunswick, ME 04011
Phone (207) 373-3012
400 Congress St
Portland, ME 04101
Phone (678) 508-1130
50 Moody St
Saco, ME 04072
Phone (207) 284-5981
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | CC1537 | ME | Yes |
Addresses
Primary practice location
17 Bishop St
Portland, ME 04103-2659
Mailing address
57 Hillis St
Portland, ME 04103-2418
Phone (207) 871-1200
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 298120099 | Medicaid | ME | |
| CAC2975 | Other | ME | ALCOHOL AND ABUSE COUNS. |
| RB9 | Other | ME | ANTHEM |
Other providers in Portland, ME
- Gretchen Hanczaryk
- Hand of Mercy Health Care, LLC
- Elizabeth Hand
- Tammy Ann Hand
- Amelia M Haney
- Emily Hanford
- Hanger Prosthetics & Orthotics Inc
- Sara Hanken
- Diane Kane Hankes
- Donald V Hankinson
All providers in Portland, ME · Mental Health 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 Aug 5, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.