Active NPI
Mica T. Slaven-Lamothe, LCSW, MHRT-CSP
- Clinical Social Worker
- Ellsworth, ME
National Provider Identifier
1003180944
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LC14722
- Practice address
- 710 Bucksport Rd
Ellsworth, ME 04605-2722 - Phone
- (207) 667-6890
- Fax
- (207) 687-6457
- NPI assigned
- Feb 23, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | |||
| Clinical Social Worker | 1041C0700X | LC14722 | ME | Primary |
Addresses
Primary practice location
710 Bucksport Rd
Ellsworth, ME 04605-2722
Mailing address
710 Bucksport Rd
Ellsworth, ME 04605-2722
Phone (207) 667-6890
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 103850000 | Medicaid | ME |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LC14722 | ME | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1329955200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1408492800000",
"number": "1003180944",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "710 BUCKSPORT RD",
"city": "ELLSWORTH",
"state": "ME",
"postal_code": "046052722",
"telephone_number": "207-667-6890",
"fax_number": "207-687-6457"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "710 BUCKSPORT RD",
"city": "ELLSWORTH",
"state": "ME",
"postal_code": "046052722",
"telephone_number": "207-667-6890",
"fax_number": "207-687-6457"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SLAVEN-LAMOTHE",
"first_name": "MICA",
"middle_name": "T.",
"credential": "LCSW, MHRT-CSP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-02-23",
"last_updated": "2014-08-20",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "ME",
"license": "LC14722",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "103850000",
"state": "ME"
}
],
"endpoints": [],
"other_names": []
}Other providers in Ellsworth, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.