JENNIFER KELLEY-YOUNG (NPI# 1164766200) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1164766200 |
Entity Type | Individual |
Full Name | JENNIFER KELLEY-YOUNG |
Credential | LADC |
Practice Address |
11 Baxter Blvd Portland ME 04101-1801 |
Practice Telephone | 2077755671 |
Practice Fax Number | 2078711243 |
Mailing Telephone | 2077755671 |
Mailing Fax Number | 2078711243 |
Enumeration Date | 2012-11-15 |
Last Update Date | 2019-07-08 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
LC6257 | ME | Behavioral Health & Social Service Providers |
Street Address |
11 BAXTER BLVD |
City | PORTLAND |
State | ME |
Zip Code | 04101-1801 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1346452646 | Debra A Ouimette | Counselor | 11 Baxter Blvd, Portland, ME 04101-1801 | 2007-05-07 |
1326519604 | Stephanie F Potts | Counselor | 11 Baxter Blvd, Portland, ME 04101-1801 | 2018-12-11 |
1124532304 | Ellen Skoczenski | Counselor | 11 Baxter Blvd, Portland, ME 04101 | 2017-11-27 |
1841647740 | Christopher Ross | Counselor | 11 Baxter Blvd, Portland, ME 04101-1801 | 2016-05-20 |
1407225030 | Katherine Mills | Nurse Practitioner | 11 Baxter Blvd, Portland, ME 04101-1801 | 2015-09-24 |
1760850564 | Renee Dubois | Counselor | 11 Baxter Blvd, Portland, ME 04101-1801 | 2015-09-10 |
1487020970 | Catholic Charities Maine | Community/Behavioral Health | 11 Baxter Blvd, Portland, ME 04101-1801 | 2015-08-19 |
1871985119 | Mary Ribble | Social Worker | 11 Baxter Blvd, Portland, ME 04101-1801 | 2015-02-24 |
1982967568 | Andrea Kelly Schachtner | Counselor | 11 Baxter Blvd, Portland, ME 04101-1801 | 2012-06-19 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1306450655 | Jocylin Egan | Nurse Practitioner | 442 Congress Street, 2nd Floor, Portland, ME 04101 | 2020-09-03 |
1255963559 | Portcity Home Healthcare LLC | In Home Supportive Care | 525 Forest Avenue, Suite 8, Portland, ME 04101 | 2020-02-05 |
1578101929 | Mohamed Hassan Mohamed | Student in an Organized Health Care Education/Training Program | 75 Lancaster St Ste 218a, Portland, ME 04101 | 2019-12-17 |
1841855301 | Portland Opioid Health Home | Counselor | 48 Free St., Mezzanine Level, Portland, ME 04101 | 2019-05-09 |
1093379224 | Alexandra Strawbridge Maurer | Acupuncturist | 50 A Cove Street, Portland, ME 04101 | 2019-04-23 |
1245719541 | Scott J Whited | Nurse Practitioner | 216 Vaughan St., Mcgeachy Hall, Portland, ME 04101 | 2018-08-08 |
1144733064 | Alixandria Elaine Marie Winchell | Massage Therapist | One City Center, Portland, ME 04101 | 2017-11-14 |
1417473638 | Rachel S Schwaner | Occupational Therapist | 78 Danforth Street, Apartment 6, Portland, ME 04101 | 2017-08-18 |
1023538154 | Derina Boothroyd | Audiologist-Hearing Aid Fitter | 985 Forest Ave., Portland, ME 04101 | 2017-06-20 |
1881123297 | Mark Mccullough | Social Worker | 57 Exchange Street, Suite 403, Portland, ME 04101 | 2017-06-08 |
Find all providers in zip 04101 |
Taxonomy Code | 101YA0400X |
Grouping | Behavioral Health & Social Service Providers |
Classification | Counselor |
Specialization | Addiction (Substance Use Disorder) |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1477163657 | Kevin Charles Reiser | Counselor | 2318 Ne Martin Luther King Blvd, Portland, OR 97212-3715 | 2020-08-03 |
1881203628 | Beau Curtiss | Counselor | 7916 Se Foster Rd Ste 203, Portland, OR 97206-4289 | 2020-07-28 |
1851916886 | Jonathan Cross | Counselor | 49 Montrose Ave Apt 3, Portland, ME 04103-2442 | 2020-06-16 |
1639703960 | Elizabeth Ann Anderson | Counselor | 1820 Sw Vermont St Ste J, Portland, OR 97219-1945 | 2020-02-25 |
1194356618 | Deforrest Kwesi Jackson | Counselor | 122 Ne 122nd Ave Ste 200, Portland, OR 97230-2103 | 2020-02-03 |
1760012942 | Jesse Decker | Counselor | 7015 N Boston Ave, Portland, OR 97217-5711 | 2020-01-16 |
1740829076 | Ryan Christianson | Counselor | 2707 Ne Flanders St, Portland, OR 97232-3159 | 2020-01-03 |
1083264477 | Kayla Rose Paris | Counselor | 420 Cumberland Ave, Portland, ME 04101-2823 | 2019-09-17 |
1275193260 | Anna Khval | Counselor | 1500 Se 122nd Ave, Portland, OR 97233-1207 | 2019-06-20 |
1841855301 | Portland Opioid Health Home | Counselor | 48 Free St., Mezzanine Level, Portland, ME 04101 | 2019-05-09 |
Find all providers in PORTLAND |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.