Individual provider Active NPI

Alice M. Dunworth, LCSW

  • Clinical Social Worker
  • Portland, ME
National Provider Identifier
1154625762
Registry record updated Sep 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LC4240 Issued in ME
Practice address
165 Lancaster St
Portland, ME 04101-2406
Phone
(207) 874-1030
Fax
(207) 874-1044
NPI assigned
Dec 23, 2010
Sex
Female
Sole proprietor
No

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LC4240MEMDClinical Social Worker

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LC4240 ME Primary

Addresses

NPPES NPI Registry

Primary practice location

165 Lancaster St
Portland, ME 04101-2406

Mailing address

78 Atlantic PL
South Portland, ME 04106-2316
Phone (207) 842-7701

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Sep 11, 2012.

{
    "created_epoch": "1293062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1347321600000",
    "number": "1154625762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "78 ATLANTIC PL",
            "city": "SOUTH PORTLAND",
            "state": "ME",
            "postal_code": "041062316",
            "telephone_number": "207-842-7701",
            "fax_number": "207-842-7773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "165 LANCASTER ST",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041012406",
            "telephone_number": "207-874-1030",
            "fax_number": "207-874-1044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUNWORTH",
        "first_name": "ALICE",
        "middle_name": "M.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-12-23",
        "last_updated": "2012-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ME",
            "license": "LC4240",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2012; 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.