Marjorie Elaine Averill, MSW LCSW
Individual provider Active NPI Mental Health Counselor · Damariscotta, ME
NPI 1063503522 · NPPES record last updated Mar 5, 2013
Key facts
- NPI
- 1063503522
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- License
- LC7078 (ME)
- Practice address
- 73 Biscay Road
Damariscotta, ME 04542 - Phone
- (207) 563-3022
- Fax
- (207) 563-3061
- NPI assigned
- Sep 27, 2006
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 3
Medicare Care Compare profile
- Specialty
- Clinical Social Worker
- Education
- Other, 1998
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Sweetser
Practice addresses (Care Compare)
50 Moody St
Saco, ME 04072-1536
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in ME
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20060227000491 | ME | Practitioner - Clinical Social Worker | 9739195819 |
Reassigns benefits to 1 organization Practice locations: Damariscotta, ME |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LC7078 | ME | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sweetser | Current |
Accepting new patients | |
| Umbrella Mental Health Services, PA | Mental Health | Past | Accepting new patients |
| Protea Behavioral Health Services | Past | Accepting new patients |
Locations
28 Sweetser Dr
Belfast, ME 04915
Phone (207) 284-5981
66 Chapman St
Ste E
Damariscotta, ME 04543
Phone (207) 563-3022
50 Moody St
Saco, ME 04072
Phone (207) 284-5981
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | LC7078 | ME | Yes |
Addresses
Primary practice location
73 Biscay Road
Damariscotta, ME 04542
Mailing address
PO Box 157
Nobleboro, ME 04555
Phone (207) 563-3022
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 432269200 | Medicaid | ME | |
| 204920100 | Medicaid | ME | |
| 1700996063 | Other | ME | NPI |
Other providers in Damariscotta, ME
- Lori Ann
- Lydia Ann Atkins
- Joan M Atkinson
- Mary W Auslander
- Jennifer Ann Averill
- Janet Dorothy Azevedo
- Megan Mary Bain
- Gray A Baldwin
- Michael Scott Baldwin
- Reatha W. Ballard
All providers in Damariscotta, ME · Mental Health Counselor in Maine
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 5, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.