MR. LEE TODD LACKS (NPI# 1285918383) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285918383 |
| Entity Type | Individual |
| Full Name | MR. LEE TODD LACKS |
| Credential | LCPC-C, MT-BC |
| Practice Address |
9 Lemont Ave South Portland ME 04106-5717 |
| Practice Telephone | 2072106045 |
| Enumeration Date | 2011-10-06 |
| Last Update Date | 2011-10-06 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 251C00000X | Day Training, Developmentally Disabled Services | XL3782 | ME | Agencies |
| Y | 251S00000X | Community/Behavioral Health | XL3782 | ME | Agencies |
| Street Address |
9 LEMONT AVE |
| City | SOUTH PORTLAND |
| State | ME |
| Zip Code | 04106-5717 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912513748 | Rayna Louise Sage | Behavior Technician | 50 Donald Beaver Drrive, Ste B, Portland, ME 04106 | 2020-09-17 |
| 1972127330 | Scott M Davis Md LLC | Internal Medicine | 89 Cannon Road, South Portland, ME 04106 | 2020-06-02 |
| 1568013936 | Clara Cassidy | Behavior Technician | 50 Donald Bean Dr, Ste B, South Portland, ME 04106 | 2019-09-26 |
| 1336614346 | Kari Whitney | Nurse Practitioner | Vna Home Health Hospice, 50 Foden Road, Suite 1, South Portland, ME 04106 | 2018-10-05 |
| 1588152193 | Kristen F. Pierce | Counselor | 100 Waterman Drive, Suite 201, South Portland, ME 04106 | 2018-04-30 |
| 1649779224 | Jennifer Rene Johnson | Social Worker | 135 Westbrook St, South Portland, ME 04106 | 2018-02-08 |
| 1154847721 | Integral Nutrition, LLC | Dietitian, Registered | 59 Baltimore Avenue, South Portland, ME 04106 | 2017-08-16 |
| 1730619610 | John Preston Powell | Psychiatry & Neurology | 68 B Street Apt 4, South Portland, ME 04106 | 2017-06-14 |
| 1649706268 | Gisselle Mani | Student in an Organized Health Care Education/Training Program | 30 Lydia Ln Apt 2115, South Portland, ME 04106 | 2017-05-02 |
| 1245786987 | Jonathan Frank Olmes | Optometrist | 335 Maine Mall Rd., South Portland, ME 04106 | 2016-09-01 |
| Find all providers in zip 04106 | ||||
| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700334307 | Within Reach LLC | Community/Behavioral Health | 169 Ocean St Ste 201, South Portland, ME 04106-3636 | 2016-09-13 |
| 1962800755 | Sinfonia Family Services of Maine, Inc | Community/Behavioral Health | 207 Gannett Dr Ste 3, South Portland, ME 04106-6910 | 2014-12-11 |
| 1972830529 | Gouzie Associates, Inc. | Community/Behavioral Health | 91 Deake St, South Portland, ME 04106-3111 | 2009-11-03 |
| 1386007045 | Connections for Kids | Community/Behavioral Health | 100 Gannett Dr, South Portland, ME 04106-5900 | 2016-03-31 |
| 1831474493 | Maps | Community/Behavioral Health | 100 Brickhill Ave, South Portland, ME 04106-1999 | 2011-10-14 |
| 1538484266 | Maps | Community/Behavioral Health | 100 Brickhill Ave, South Portland, ME 04106-1999 | 2010-04-06 |
| 1588989677 | Youth Alternatives Ingraham | Community/Behavioral Health | 50 Lydia Ln, South Portland, ME 04106-2156 | 2010-03-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609476852 | Allied Community Services LLC | Community/Behavioral Health | 476 Sabattus St, Lewiston, ME 04240-4111 | 2020-10-27 |
| 1124627765 | Peace Care Services LLC | Community/Behavioral Health | 145 Lisbon St Ste 508, Lewiston, ME 04240-7241 | 2020-10-24 |
| 1770181877 | Renewal Family Center, LLC | Community/Behavioral Health | 10 Learners Drive, Augusta, ME 04330 | 2020-10-12 |
| 1790302677 | Hope for All Community Services LLC | Community/Behavioral Health | 68 Bishop St, Building 1, Unit 1, Portland, ME 04103 | 2020-06-26 |
| 1497371868 | Touchstone Support Services LLC | Community/Behavioral Health | 247 Lisbon St # 2, Lewiston, ME 04240-7704 | 2020-06-22 |
| 1770106916 | Rolling Hills Enterprises, Inc. | Community/Behavioral Health | 124 Canal St Ste 2, Lewiston, ME 04240-7711 | 2020-05-22 |
| 1871134478 | Nicole Mank, Lcsw, LLC | Community/Behavioral Health | 126 Western Ave # 1026, Augusta, ME 04330-7249 | 2019-10-04 |
| 1699328336 | Nancy Yombe | Community/Behavioral Health | 280 Stetson Rd, Lewiston, ME 04240-2430 | 2019-07-22 |
| 1942867676 | At The Helm Counseling and Case Management, LLC | Community/Behavioral Health | 64 Paris St, Norway, ME 04268-5634 | 2019-05-29 |
| 1629530530 | Fraser Clinical Consultation Services, LLC | Community/Behavioral Health | 96 Harlow St Ste 214, Bangor, ME 04401-4981 | 2019-04-01 |
| Find all providers with the same taxonomy | ||||
| City | SOUTH PORTLAND |
| Zip Code | 04106 |
Please comment or provide details below to improve the information on MR. LEE TODD LACKS.
| 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.