Individual provider Active NPI

Cheria Clow Rollins, LCSW

  • Clinical Social Worker
  • Eliot, ME
National Provider Identifier
1104028125
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LC12855 Issued in ME
Practice address
28 Levesque Dr
Eliot, ME 03903-2078
Phone
(207) 351-6932
NPI assigned
Jun 1, 2007
Last updated
Mar 17, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X CAC4970 ME
Clinical Social Worker 1041C0700X LC12855 ME Primary

Addresses

Primary practice location

28 Levesque Dr
Eliot, ME 03903-2078

Mailing address

PO Box 925
Kittery, ME 03904-0925
Phone (207) 351-6932

Other practice location 1

15 Hospital Dr
York, ME 03909-1011
Phone (207) 351-2118

Other identifiers 1

IdentifierTypeStateIssuer
1376528398OtherMEYORK HOSPITAL NPI#

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
I20110127000398 ME Practitioner - Clinical Social Worker 6608055314 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
SweetserGroup PAC ID 8325946213, 138 clinicians

Practice addresses (Care Compare)

329 Bath Rd
Brunswick, ME 04011-2673
Phone (207) 373-3177

50 Moody St
Saco, ME 04072-1536
Phone (800) 434-3000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CAC4970MEMDAddiction (Substance Use Disorder) Counselor
LC12855MEMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Sweetser CurrentSince Dec 3, 2017 Accepting new patients

Locations

329 Bath Rd
Brunswick, ME 04011
Phone (207) 373-3012

50 Moody St
Saco, ME 04072
Phone (207) 284-5981

Organizations & group practices 1

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": "1180656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1104028125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 925",
            "city": "KITTERY",
            "state": "ME",
            "postal_code": "039040925",
            "telephone_number": "207-351-6932"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28 LEVESQUE DR",
            "city": "ELIOT",
            "state": "ME",
            "postal_code": "039032078",
            "telephone_number": "207-351-6932"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15 Hospital Dr",
            "address_purpose": "LOCATION",
            "city": "York",
            "state": "ME",
            "postal_code": "039091011",
            "country_code": "US",
            "telephone_number": "207-351-2118",
            "fax_number": "207-351-2189",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLOW ROLLINS",
        "first_name": "CHERIA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-01",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "ME",
            "license": "CAC4970",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ME",
            "license": "LC12855",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "YORK HOSPITAL NPI#",
            "identifier": "1376528398",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Eliot, ME

Sources for this page

Verify at the official NPI Registry.