Individual provider Active NPI

Cindy Daniels, LCSW

  • Clinical Social Worker
  • Scarborough, ME
National Provider Identifier
1053375733
Registry record updated Jun 30, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LC5011 Issued in ME
Practice address
200 Professional Drive
Scarborough, ME 04074-8434
Phone
(207) 883-0711
Fax
(207) 883-2204
NPI assigned
Apr 12, 2006
Last updated
Jun 30, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2010

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 LC5011 ME Primary

Addresses

Primary practice location

200 Professional Drive
Scarborough, ME 04074-8434

Mailing address

200 Professional Drive
Scarborough, ME 04074-8434
Phone (207) 883-0711

Other names 1

  • Cindy Smallidge 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
I20050822000228 ME Practitioner - Clinical Social Worker 4284664020 Practice locations: Scarborough, ME

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

636 US Route 1
Scarborough, ME 04074-9700
Phone (207) 229-8819

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Sweetser Past Accepting new patients
Integrated Behavioral Healthcare Past Accepting new patients

Organizations & group practices 2

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": "1144800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277856000000",
    "number": "1053375733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 PROFESSIONAL DRIVE",
            "city": "SCARBOROUGH",
            "state": "ME",
            "postal_code": "040748434",
            "telephone_number": "207-883-0711",
            "fax_number": "207-883-2204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 PROFESSIONAL DRIVE",
            "city": "SCARBOROUGH",
            "state": "ME",
            "postal_code": "040748434",
            "telephone_number": "207-883-0711",
            "fax_number": "207-883-2204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANIELS",
        "first_name": "CINDY",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-12",
        "last_updated": "2010-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ME",
            "license": "LC5011",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CINDY",
            "last_name": "SMALLIDGE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Scarborough, ME

Sources for this page

Verify at the official NPI Registry.