Angie M. Shahmoradi, LCSW
Individual provider Active NPI Clinical Social Worker · Fairfield, ME
NPI 1164567905 · NPPES record last updated Mar 28, 2025
Key facts
- NPI
- 1164567905
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- LC17434 (ME)
- Practice address
- PO Box 358
Fairfield, ME 04937-0358 - Phone
- (207) 453-4708
- Fax
- (207) 453-7064
- NPI assigned
- Feb 20, 2007
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Clinical Social Worker
- Education
- Other, 2000
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
1604 Benton Ave
Benton, ME 04901-3327
Phone (207) 453-4708
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in ME
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20181030001378 | ME | Practitioner - Clinical Social Worker | 0648411371 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | LC17434 | ME | Yes |
Addresses
Primary practice location
PO Box 358
Fairfield, ME 04937-0358
Mailing address
PO Box 358
Fairfield, ME 04937-0358
Phone (207) 453-4708
Other names
- Miss Angie M. Collins
Other providers in Fairfield, ME
- Sara Rivera
- Sara P Roberts
- Madison Nancy Root
- Shane G Savage
- Karren S Seely
- Roberta E Shaw
- Clayton Smith
- Luc Snipe
- Carrie Stackpole
- Christine Marie Stevens-Sheehan
All providers in Fairfield, ME · Clinical Social Worker in Maine
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 28, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.