Individual provider Active NPI

Freeman R. Corey, LCSW, LADC, CCS

  • Clinical Social Worker
  • Caribou, ME
National Provider Identifier
1053479915
Registry record updated Feb 2, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LC3744 Issued in ME
Practice address
7 Hatch Dr
Suite 240
Caribou, ME 04736-2159
Phone
(207) 498-2400
Fax
(207) 498-2400
NPI assigned
Dec 4, 2006
Last updated
Feb 2, 2016By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 2, 2016

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X LC901 ME
Addiction (Substance Use Disorder) Counselor 101YA0400X CCS3537 ME
Clinical Social Worker 1041C0700X LC3744 ME Primary

Addresses

Primary practice location

7 Hatch Dr
Suite 240
Caribou, ME 04736-2159

Mailing address

899 Riverside St
Suite 240
Portland, ME 04103-1070
Phone (207) 871-1211

Other identifiers 2

IdentifierTypeStateIssuer
098153OtherMEANTHEM BCBS NUMBER
431586399MedicaidME

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
I20070504000172 ME Practitioner - Clinical Social Worker 5799881983 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Spurwink Services IncorporatedGroup PAC ID 7810026945, 87 clinicians

Practice addresses (Care Compare)

9 Hillcrest Ave
Randolph, ME 04346-5131
Phone (207) 582-9205

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CCS3537MEMDAddiction (Substance Use Disorder) Counselor
LC901MEMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Spurwink Services Incorporated CurrentSince Feb 27, 2017 Accepting new patients
Spurwink Services Incorporated Past Accepting new patients

Locations

901 Washington Ave
Ste 100
Portland, ME 04103
Phone 20787112112145

9 Hillcrest Ave
Randolph, ME 04346
Phone (207) 582-9205

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": "1165190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1454371200000",
    "number": "1053479915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "899 RIVERSIDE ST",
            "address_2": "SUITE 240",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041031070",
            "telephone_number": "207-871-1211",
            "fax_number": "207-871-1232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 HATCH DR",
            "address_2": "SUITE 240",
            "city": "CARIBOU",
            "state": "ME",
            "postal_code": "047362159",
            "telephone_number": "207-498-2400",
            "fax_number": "207-498-2400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COREY",
        "first_name": "FREEMAN",
        "middle_name": "R.",
        "name_prefix": "Mr.",
        "credential": "LCSW, LADC, CCS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-04",
        "last_updated": "2016-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "ME",
            "license": "LC901",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "ME",
            "license": "CCS3537",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ME",
            "license": "LC3744",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS NUMBER",
            "identifier": "098153",
            "state": "ME"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "431586399",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Caribou, ME

Sources for this page

Verify at the official NPI Registry.