Christina Wall, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LC16976 Issued in ME

Practice address

162 Main St
Presque Isle, ME 04769

Phone

(207) 768-3304

Fax

(207) 540-1350

NPI assigned

Aug 4, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Aroostook Mental Health Services, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Presque Isle, ME
  • NPI 1487601399

  Clinical

  Medicare reassignment NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1438646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612224000000",
    "number": "1073999892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 ACADEMY ST STE 3",
            "city": "PRESQUE ISLE",
            "state": "ME",
            "postal_code": "047693183",
            "telephone_number": "207-554-2352",
            "fax_number": "207-554-2351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "162 MAIN ST",
            "city": "PRESQUE ISLE",
            "state": "ME",
            "postal_code": "04769",
            "telephone_number": "207-768-3304",
            "fax_number": "207-540-1350"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "180 Academy St Ste 2",
            "address_purpose": "LOCATION",
            "city": "Presque Isle",
            "state": "ME",
            "postal_code": "047693183",
            "country_code": "US",
            "telephone_number": "207-764-3319",
            "fax_number": "207-768-5377",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALL",
        "first_name": "CHRISTINA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-04",
        "last_updated": "2021-02-02",
        "certification_date": "2021-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ME",
            "license": "LC16976",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alejo Visuara Maldonado, MD
• Jennifer Waddell, PT
• Wal-Mart Stores East LP
• Wal-Mart Stores East, LP
• Walgreen Eastern Co Inc
• Amanda Martha Ward
• Norma K Watson, LCSW
• Laurence A Watterson, M.D.
• Laurie Lynn Weatherhead
• Barry Wecker, MD

• Clinical Social Worker in Presque Isle, ME
• Providers in Presque Isle, ME by specialty
• Clinical Social Worker in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.