Amy Jo Vandorn, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LC11037 Issued in ME

Practice address

249 N Deer Isle Rd
Deer Isle-Stonington Elementary School
Deer Isle, ME 04627-3432

Phone

(207) 460-6304

NPI assigned

Oct 25, 2007

Last updated

May 6, 2016By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Practice roles

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.

• Spurwink Services Incorporated

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Portland, ME
  • NPI 1760507297
  Medicare reassignment
• New Life Mission

  dba Bangor Counseling Center

  • Community/Behavioral Health Agency
  • Bangor, ME
  • NPI 1851432041
  NPD (past)

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

{
    "created_epoch": "1193270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1462492800000",
    "number": "1144409210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 426",
            "city": "HANCOCK",
            "state": "ME",
            "postal_code": "046400426",
            "telephone_number": "207-460-6304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "249 N DEER ISLE RD",
            "address_2": "DEER ISLE-STONINGTON ELEMENTARY SCHOOL",
            "city": "DEER ISLE",
            "state": "ME",
            "postal_code": "046273432",
            "telephone_number": "207-460-6304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDORN",
        "first_name": "AMY",
        "middle_name": "JO",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-10-25",
        "last_updated": "2016-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ME",
            "license": "LC11037",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hollan S Oliver, DPT
• Alison Allen Richards, PTA
• Tanya Lee Ruzyckij, OCCUPATIONAL THERAPY
• Elinor A Spencer, OTL
• Robin Vanbuskirk

• Clinical Social Worker in Deer Isle, ME
• Providers in Deer 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 May 6, 2016; 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.