Individual provider Active NPI

Laurie Sivonen, LCSW

  • Clinical Social Worker
  • Saco, ME
National Provider Identifier
1053567867
Registry record updated Oct 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LC11993 Issued in ME
Practice address
4 Scammon St Ste 19-399
Saco, ME 04072-5121
Phone
(207) 221-6644
Fax
(207) 510-8021
NPI assigned
Aug 12, 2008
Last updated
Oct 20, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 20, 2023

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 LC11993 ME Primary

Addresses

Primary practice location

4 Scammon St Ste 19-399
Saco, ME 04072-5121

Mailing address

6 Sokokis Cir
Saco, ME 04072-1874
Phone (207) 221-6644

Other identifiers 1

IdentifierTypeStateIssuer
432872299MedicaidME

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
I20161128000892 ME Practitioner - Clinical Social Worker 2466731906 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2006
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

6 Sokokis Cir
Saco, ME 04072-1874
Phone (207) 221-6644

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

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, 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": "1218499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697760000000",
    "number": "1053567867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 SOKOKIS CIR",
            "city": "SACO",
            "state": "ME",
            "postal_code": "040721874",
            "telephone_number": "207-221-6644",
            "fax_number": "207-510-8021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 SCAMMON ST STE 19-399",
            "city": "SACO",
            "state": "ME",
            "postal_code": "040725121",
            "telephone_number": "207-221-6644",
            "fax_number": "207-510-8021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIVONEN",
        "first_name": "LAURIE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-08-12",
        "last_updated": "2023-10-20",
        "certification_date": "2022-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ME",
            "license": "LC11993",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "432872299",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saco, ME

Sources for this page

Verify at the official NPI Registry.