Individual provider Active NPI

Terah Rebekah Watson, LCSW, LADC

  • Clinical Social Worker
  • Springvale, ME
National Provider Identifier
1003143900
Registry record updated Feb 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LC14502 Issued in ME
Practice address
474 Main St
Springvale, ME 04083-1409
Phone
(844) 292-0111
Fax
(207) 490-5263
NPI assigned
Nov 13, 2009
Last updated
Feb 10, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X LC4155 ME
Clinical Social Worker 1041C0700X LC14502 ME Primary

Addresses

Primary practice location

474 Main St
Springvale, ME 04083-1409

Mailing address

474 Main St
Springvale, ME 04083-1409
Phone (844) 292-0111

Other practice location 1

12 Union St
Rockland, ME 04841-2739
Phone (844) 292-0111

Other practice location 2

165 Lancaster St
Portland, ME 04101-2406
Phone (844) 292-0111

Other names 1

  • Terah R. Ames Former name

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20140311001673 ME Practitioner - Clinical Social Worker 4789814849 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
97.93 of 100Reported as apm
Quality
83.31
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LC4155MEMDAddiction (Substance Use Disorder) Counselor
LC14502MEMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Mainehealth CurrentSince Nov 1, 2018 Accepting new patients
Mainehealth CurrentSince Jun 12, 2018 Accepting new patients
Mainehealth CurrentSince Nov 1, 2018 Accepting new patients
Mainehealth CurrentSince Jun 12, 2018 Accepting new patients
Mainehealth Current Accepting new patients
Day One Addiction (Substance Use Disorder) PastSince Jun 1, 2020 Accepting new patients

Locations

1 Medical Dr
Biddeford, ME 04005
Phone (207) 283-7000

165 Lancaster St
Portland, ME 04101
Phone (207) 661-3500

22 Bramhall St
Portland, ME 04102
Phone (207) 662-2179

12 Union St
Rockland, ME 04841
Phone (207) 701-4400

78 Atlantic Pl
South Portland, ME 04106
Phone (207) 661-6654

474 Main St
Springvale, ME 04083
Phone (207) 324-1500

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1258070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739145600000",
    "number": "1003143900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "474 MAIN ST",
            "city": "SPRINGVALE",
            "state": "ME",
            "postal_code": "040831409",
            "telephone_number": "844-292-0111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "474 MAIN ST",
            "city": "SPRINGVALE",
            "state": "ME",
            "postal_code": "040831409",
            "telephone_number": "844-292-0111",
            "fax_number": "207-490-5263"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12 Union St",
            "address_purpose": "LOCATION",
            "city": "Rockland",
            "state": "ME",
            "postal_code": "048412739",
            "country_code": "US",
            "telephone_number": "844-292-0111",
            "fax_number": "207-701-4487",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "165 Lancaster St",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "ME",
            "postal_code": "041012406",
            "country_code": "US",
            "telephone_number": "844-292-0111",
            "fax_number": "207-874-1044",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WATSON",
        "first_name": "TERAH",
        "middle_name": "REBEKAH",
        "credential": "LCSW, LADC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-11-13",
        "last_updated": "2025-02-10",
        "certification_date": "2025-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "ME",
            "license": "LC4155",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ME",
            "license": "LC14502",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TERAH",
            "last_name": "AMES",
            "middle_name": "R.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Springvale, ME

Sources for this page

Verify at the official NPI Registry.