Individual provider Active NPI

Lisa Marie Macdonald, MSW

  • Clinical Social Worker
  • Kennebunk, ME
National Provider Identifier
1073968905
Registry record updated Oct 24, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LC8956 Issued in ME
Practice address
4 Campbell Cir
Kennebunk, ME 04043-6838
Phone
(207) 985-9939
NPI assigned
Apr 28, 2016
Last updated
Oct 24, 2016By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 24, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X SW110393-1 MA
Clinical Social Worker 1041C0700X LC8956 ME Primary

Addresses

Primary practice location

4 Campbell Cir
Kennebunk, ME 04043-6838

Mailing address

4 Campbell Cir
Kennebunk, ME 04043-6838
Phone (207) 985-9939

Other names 1

  • Lisa Marie Crowley Professional name

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
I20160818001854 ME Practitioner - Clinical Social Worker 2769408160 Practice locations: Kennebunk, ME

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

62 Portland Rd
Suite 42
Kennebunk, ME 04043-6650
Phone (207) 482-0588

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW110393-1MAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Tim Ericson, LLC Clinical Past Accepting new patients
Lisa Crowley LCSW LLC Clinical Past Accepting new patients

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": "1461801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477267200000",
    "number": "1073968905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 CAMPBELL CIR",
            "city": "KENNEBUNK",
            "state": "ME",
            "postal_code": "040436838",
            "telephone_number": "207-985-9939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 CAMPBELL CIR",
            "city": "KENNEBUNK",
            "state": "ME",
            "postal_code": "040436838",
            "telephone_number": "207-985-9939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACDONALD",
        "first_name": "LISA",
        "middle_name": "MARIE",
        "credential": "MSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-04-28",
        "last_updated": "2016-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "SW110393-1",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ME",
            "license": "LC8956",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LISA",
            "last_name": "CROWLEY",
            "middle_name": "MARIE",
            "credential": "MSW",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Kennebunk, ME

Sources for this page

Verify at the official NPI Registry.