Katherine Elizabeth Box, LCSW
Individual provider Active NPI Social Worker · Northport, ME
NPI 1063570950 · NPPES record last updated Mar 1, 2012
Key facts
- NPI
- 1063570950
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Social Worker 104100000X
- License
- LC13400 (ME)
- Practice address
- 1295 Atlantic Hwy.
Northport, ME 04849-3600 - Phone
- (207) 470-7090
- Fax
- (207) 470-7094
- NPI assigned
- Dec 5, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 5
Medicare Care Compare profile
- Specialty
- Clinical Social Worker
- Education
- Other, 2008
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Talkspace Provider Network PA
Health Affiliates Maine, LLC
Practice addresses (Care Compare)
3 Cooper Rd
Morrill, ME 04952-5048
Phone (207) 542-2083
306 Rodman Rd
Auburn, ME 04210-3830
Phone (207) 333-3278
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (5 enrollments) in ME, FL, NH, MN, CA
- 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 |
|---|---|---|---|---|
| I20150327002220 | ME | Practitioner - Clinical Social Worker | 1254658370 | Reassigns benefits to 3 organizations |
| I20251218000923 | FL | Practitioner - Clinical Social Worker | 1254658370 | Reassigns benefits to 1 organization |
| I20251222003086 | NH | Practitioner - Clinical Social Worker | 1254658370 | Reassigns benefits to 1 organization |
| I20251223003774 | MN | Practitioner - Clinical Social Worker | 1254658370 | Reassigns benefits to 1 organization |
| I20260213000772 | CA | Practitioner - Clinical Social Worker | 1254658370 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LC13400 | ME | MD | Social Worker |
| LSX9781 | ME | MD | Clinical Social Worker |
| 3526 | NH | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Health Affiliates Maine, LLC | Current |
Accepting new patients | |
| Thrive Counseling LLC | Current |
Accepting new patients | |
| Talkspace Provider Network PA | Current |
Accepting new patients | |
| Talkspace Provider Network Ca PC | Current |
Accepting new patients | |
| Manely Hope and Healing, PLLC | Past |
Accepting new patients |
Locations
306 Rodman Rd
Auburn, ME 04210
Phone (207) 333-3278
550 Forest Ave
Ste 201
Portland, ME 04101
Phone (207) 420-2759
2578 Broadway
#607
New York, NY 10025
Phone (516) 847-5432
2578 Broadway
Ste 607
New York, NY 10025
Phone (304) 308-3735
1000 Jefferson St
Ste 2C
Lynchburg, VA 24504
Phone (434) 528-3263
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | LSX9781 | ME | |
| Social Worker | 104100000X | LC13400 | ME | Yes |
Addresses
Primary practice location
1295 Atlantic Hwy.
Northport, ME 04849-3600
Mailing address
1295 Atlantic Hwy
Northport, ME 04849-3600
Phone (207) 470-7090
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 104000000 | Medicaid | ME |
Other names
- Katherine Elizabeth Pederson (Maiden Name)
Other providers in Northport, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 1, 2012. 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.