Individual provider Active NPI

Shane Sullivan Simpson, LCSW

  • Clinical Social Worker
  • Lewiston, ME
National Provider Identifier
1053471995
Registry record updated May 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LC8693 Issued in ME
Practice address
230 Bartlett St
Lewiston, ME 04240-6578
Phone
(207) 783-4695
NPI assigned
Dec 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 26, 2026

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 LC8693 ME Primary

Addresses

Primary practice location

230 Bartlett St
Lewiston, ME 04240-6578

Mailing address

164 Intervale Rd
New Gloucester, ME 04260-3812
Phone (207) 807-5610

Other practice location 1

9 Green St
Augusta, ME 04330-7451
Phone (207) 621-3790

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
I20040810000727 ME Practitioner - Clinical Social Worker 1456323401 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mainegeneral HealthGroup PAC ID 2163316548, 11 clinicians

Practice addresses (Care Compare)

9 Green St
Augusta, ME 04330-7451
Phone (207) 621-3750

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Mainegeneral Health CurrentSince May 22, 2023 Accepting new patients
Sweetser CurrentSince May 16, 2011 Accepting new patients
Mainegeneral Health CurrentSince May 22, 2023 Accepting new patients
Tri-County Mental Health Services PastSince Jul 28, 2005 Accepting new patients
Spurwink Services Incorporated PastSince Mar 17, 2025 Accepting new patients
Maine Behavioral Healthcare Past Accepting new patients

Locations

9 Green St
Augusta, ME 04330
Phone (207) 621-3700

28 Sweetser Dr
Belfast, ME 04915
Phone (207) 284-5981

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

149 North St
Waterville, ME 04901
Phone (207) 622-1959

Organizations & group practices 6

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": "1165795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779753600000",
    "number": "1053471995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "164 INTERVALE RD",
            "city": "NEW GLOUCESTER",
            "state": "ME",
            "postal_code": "042603812",
            "telephone_number": "207-807-5610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 BARTLETT ST",
            "city": "LEWISTON",
            "state": "ME",
            "postal_code": "042406578",
            "telephone_number": "207-783-4695"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9 Green St",
            "address_purpose": "LOCATION",
            "city": "Augusta",
            "state": "ME",
            "postal_code": "043307451",
            "country_code": "US",
            "telephone_number": "207-621-3790",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIMPSON",
        "first_name": "SHANE",
        "middle_name": "SULLIVAN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-11",
        "last_updated": "2026-05-26",
        "certification_date": "2026-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ME",
            "license": "LC8693",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lewiston, ME

Sources for this page

Verify at the official NPI Registry.