Keith A Wentzel

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

CC4458 Issued in ME

Practice address

79 Main St
Auburn, ME 04210-5811

Phone

(207) 364-7981

Fax

(877) 789-6905

NPI assigned

May 3, 2011

Sex

Male

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, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1304380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1494374400000",
    "number": "1881986388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 DANA AVE",
            "city": "AUBURN",
            "state": "ME",
            "postal_code": "042105834",
            "telephone_number": "207-240-6972",
            "fax_number": "877-789-6905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "79 MAIN ST",
            "city": "AUBURN",
            "state": "ME",
            "postal_code": "042105811",
            "telephone_number": "207-364-7981",
            "fax_number": "877-789-6905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WENTZEL",
        "first_name": "KEITH",
        "middle_name": "A",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-05-03",
        "last_updated": "2017-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "ME",
            "license": "CC4458",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Edward A Waybright, MD
• Johanna Webber, LMSW-CC
• Robert J Weiss, MD
• Calla E Wells, LCSW
• Wendy Frayer, LCSW
• Alexii West, PHARM. D.
• Shelby Westman
• Caitlin White
• Jessica J Wiers, PHARM.D.
• Morgan Renee Wilbur, DPT

• Mental Health Counselor in Auburn, ME
• Providers in Auburn, 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 May 10, 2017; 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.