Individual provider Active NPI

Lynn I Watson, LCSW

  • Clinical Social Worker
  • Biddeford, ME
National Provider Identifier
1043296155
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LC8208 Issued in ME
Practice address
10 May St
Biddeford, ME 04005-2923
Phone
(207) 205-2560
Fax
(207) 284-7861
NPI assigned
Dec 20, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LC8208 ME Primary

Addresses

Primary practice location

10 May St
Biddeford, ME 04005-2923

Mailing address

110 Main Street #104
Saco, ME 04072
Phone (207) 205-2560

Other practice location 1

655 Main St
Saco, ME 04072-1543
Phone (207) 602-3571

Other identifiers 2

IdentifierTypeStateIssuer
243170099MedicaidME
30424269MedicaidME

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

LicenseStateTypeSpecialty
LC8208MEMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1135036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1043296155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 MAIN STREET #104",
            "city": "SACO",
            "state": "ME",
            "postal_code": "04072",
            "telephone_number": "207-205-2560",
            "fax_number": "207-284-7861"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 MAY ST",
            "city": "BIDDEFORD",
            "state": "ME",
            "postal_code": "040052923",
            "telephone_number": "207-205-2560",
            "fax_number": "207-284-7861"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "655 Main St",
            "address_purpose": "LOCATION",
            "city": "Saco",
            "state": "ME",
            "postal_code": "040721543",
            "country_code": "US",
            "telephone_number": "207-602-3571",
            "fax_number": "207-602-3573",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WATSON",
        "first_name": "LYNN",
        "middle_name": "I",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-12-20",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ME",
            "license": "LC8208",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "243170099",
            "state": "ME"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30424269",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Biddeford, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.