Shelagh Costello, OT

Individual provider Active NPI Occupational Therapist · Casco, ME

NPI 1013306091 · NPPES record last updated Jan 14, 2015

Key facts

NPI
1013306091
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapist 225X00000X
License
11007 (MA)
Practice address
3 Glen Dr
Casco, ME 04015-3833
Phone
(800) 995-2673
Fax
(888) 979-6551
NPI assigned
Jan 14, 2015
Sex
Female
Sole proprietor
Yes

Organizations & group practices 1

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

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
11007MAMDPsychologist
OT01406RIMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Excella Homecare, Inc. Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 11007 MA Yes
Occupational Therapist 225X00000X OT01406 RI

Addresses

Primary practice location

3 Glen Dr
Casco, ME 04015-3833

Mailing address

3 Glen Dr
Casco, ME 04015-3833
Phone (800) 995-2673

Other providers in Casco, ME

All providers in Casco, ME · Occupational Therapist in Maine

Sources for this page

Verify at the official NPI Registry.