Individual provider Active NPI

Chelsea Victoria Short, LCSW

  • Clinical Social Worker
  • Augusta, ME
National Provider Identifier
1023512779
Registry record updated Dec 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LC19630 Issued in ME
Practice address
10 Caldwell Rd
Augusta, ME 04330-5735
Phone
(207) 616-6849
NPI assigned
Mar 19, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 5, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X MC17091 ME
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X LC19630 ME Primary

Addresses

Primary practice location

10 Caldwell Rd
Augusta, ME 04330-5735

Mailing address

257 Northern Ave
Augusta, ME 04330-3900
Phone (207) 616-6849

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
I20220510000905 ME Practitioner - Clinical Social Worker 9931586187 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
SweetserGroup PAC ID 8325946213, 138 clinicians

Practice addresses (Care Compare)

329 Bath Rd
Brunswick, ME 04011-2673
Phone (207) 373-3177

50 Moody St
Saco, ME 04072-1536
Phone (800) 434-3000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LC19630MEMDClinical Social Worker
MC17091MEMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Sweetser Single Specialty CurrentSince Dec 19, 2024 Accepting new patients

Locations

329 Bath Rd
Brunswick, ME 04011
Phone (207) 373-3012

50 Moody St
Saco, ME 04072
Phone (207) 284-5981

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.

NPI Registry JSON

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

{
    "created_epoch": "1521417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670198400000",
    "number": "1023512779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "257 NORTHERN AVE",
            "city": "AUGUSTA",
            "state": "ME",
            "postal_code": "043303900",
            "telephone_number": "207-616-6849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 CALDWELL RD",
            "city": "AUGUSTA",
            "state": "ME",
            "postal_code": "043305735",
            "telephone_number": "207-616-6849"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHORT",
        "first_name": "CHELSEA",
        "middle_name": "VICTORIA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-03-19",
        "last_updated": "2022-12-05",
        "certification_date": "2022-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ME",
            "license": "MC17091",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "ME",
            "license": "LC19630",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Augusta, ME

Sources for this page

Verify at the official NPI Registry.