Individual provider Active NPI

Dara K McIntire, LCSW

  • Clinical Social Worker
  • Orono, ME
National Provider Identifier
1083127617
Registry record updated Jan 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
MC15087 Issued in ME
Practice address
163 Forest Ave
Orono, ME 04473
Phone
(207) 356-1622
NPI assigned
Nov 6, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2024

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 MC15087 ME Primary

Addresses

Primary practice location

163 Forest Ave
Orono, ME 04473

Mailing address

163 Forest Ave
Orono, ME 04473-4723
Phone (207) 356-1622

Other names 1

  • Dara Kidder Former 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
I20200825001557 ME Practitioner - Clinical Social Worker 4284051087 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

163 Forest Ave
Orono, ME 04473-3602
Phone (207) 356-1622

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MC15087MEMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Behavioral Health Center Clinical CurrentSince Jul 7, 2020 Accepting new patients
Acadia Hospital Corp CurrentSince Jul 7, 2020 Accepting new patients
Orono Counseling LLC Clinical CurrentSince Dec 15, 2020 Accepting new patients

Locations

77 Court St
Bangor, ME 04401
Phone (207) 941-0879

268 Stillwater Ave
Bangor, ME 04401
Phone (207) 973-6470

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1509926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704412800000",
    "number": "1083127617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "163 FOREST AVE",
            "city": "ORONO",
            "state": "ME",
            "postal_code": "044734723",
            "telephone_number": "207-356-1622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "163 FOREST AVE",
            "city": "ORONO",
            "state": "ME",
            "postal_code": "04473",
            "telephone_number": "207-356-1622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCINTIRE",
        "first_name": "DARA",
        "middle_name": "K",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-06",
        "last_updated": "2024-01-05",
        "certification_date": "2024-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ME",
            "license": "MC15087",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DARA",
            "last_name": "KIDDER",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Orono, ME

Sources for this page

Verify at the official NPI Registry.