Ian R C Witherby, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LC19443 Issued in ME

Practice address

12 Union St
Rockland, ME 04841-2739

Phone

(207) 352-0300

NPI assigned

Sep 4, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1599177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607299200000",
    "number": "1093329294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 UNION ST",
            "city": "ROCKLAND",
            "state": "ME",
            "postal_code": "048412739",
            "telephone_number": "207-352-0300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 UNION ST",
            "city": "ROCKLAND",
            "state": "ME",
            "postal_code": "048412739",
            "telephone_number": "207-352-0300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WITHERBY",
        "first_name": "IAN",
        "middle_name": "R C",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-09-04",
        "last_updated": "2020-12-07",
        "certification_date": "2020-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "123046",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ME",
            "license": "MC17118",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ME",
            "license": "LC19443",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sally A Williams, MA, LCPC
• Melissa Ann Williamson, LMT
• William Tobey Williamson, L.AC.
• Travis J Wilson, PHARM.D.
• Andrew F Wisch, PH.D.
• Woodlands Senior Living of Rockland, LLC (Woodlands Memory Care of Rockland)
• John Woodman
• Kristie Worster, LCSW
• Katrina Clare Wozich, CADC
• Judith Yeaton, M.S., O.T./L.

• Clinical Social Worker in Rockland, ME
• Providers in Rockland, 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 Dec 7, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.