JENNIFER L PELLETIER, LSW — NPI 1437373313 (Licensed & Credentialed Counselor in RANDOLPH, ME)

CMS-1500 Box 24J / 33a • NPI

1437373313

Type 1 Individual Rendering/Ordering

HIPAA NUCC Taxonomy • CMS Code

101Y00000X

Licensed & Credentialed Counselor

Box 32 Service Location & ZIP+4

9 HILLCREST AVE, RANDOLPH, ME, 04346-5131

✓ 9-Digit EDI 837 ZIP+4 (04346-5131)

Practice Phone & Referral Fax

(207) 582-9206

Fax: (207) 582-9652

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1437373313 (JENNIFER L PELLETIER, LSW) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

This practitioner does not currently appear in the CMS individual Order & Referring PECOS file (may practice in pediatrics, commercial-only networks, or hospital-employed settings).

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1437373313` (NPI-1 Individual Practitioner)
Provider / Legal Name	JENNIFER L PELLETIER, LSW
Plain-English Specialty	Licensed & Credentialed Counselor NUCC Code: `101Y00000X` (Counselor)
Certifying / Licensing Body	State Medical / Healthcare Licensing Board & National Specialty Board
Practice Location Address	9 HILLCREST AVE, RANDOLPH, ME, 04346-5131
Practice Telephone / Fax	Tel: (207) 582-9206 \| Fax: (207) 582-9652
Administrative Mailing Address	899 RIVERSIDE ST, PORTLAND, ME, 04103-1070
Enumeration & Last Sync	Enumerated: 2007-04-12 \| CMS Record Updated: 2019-05-16

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

9 HILLCREST AVE, RANDOLPH, ME, 04346-5131

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Plain-English Taxonomy & CMS Crosswalk (101Y00000X)

What Does Taxonomy Code 101Y00000X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 101Y00000X translates to:
"Licensed & Credentialed Counselor"

CMS-1500 Medicare Specialty Crosswalk: Standard HIPAA X12N 837P / CMS-1500
Certifying / Accrediting Authority: State Medical / Healthcare Licensing Board & National Specialty Board
Clinical Scope: Consult a verified Counselor for specialized diagnostic evaluation, treatment planning, and continuity of care.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (JENNIFER L PELLETIER, LSW)

Typical CPT / Diagnostic Procedures:

Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
Preventive Screening, Patient Counseling & Multidisciplinary Referral

Common Therapeutic Classes:

Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`171W00000X` — Contractor Plain English: Licensed & Credentialed Contractor	State: ME \| License: `LS6727` \| Primary: Secondary
`101Y00000X` — Counselor Plain English: Licensed & Credentialed Counselor	State: ME \| License: `CC4825` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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JENNIFER L PELLETIER, LSW (NPI #1437373313)