Active NPI
Angie M. Shahmoradi, LCSW
- Clinical Social Worker
- Fairfield, ME
National Provider Identifier
1164567905
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LC17434
- Practice address
- PO Box 358
Fairfield, ME 04937-0358 - Phone
- (207) 453-4708
- Fax
- (207) 453-7064
- NPI assigned
- Feb 20, 2007
- Last updated
- Mar 28, 2025
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | LC17434 | ME | Primary |
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 1
- Miss Angie M. Collins
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- 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
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LC17434 | ME | MD | Clinical Social Worker |
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": "1171929600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1743120000000",
"number": "1164567905",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 358",
"city": "FAIRFIELD",
"state": "ME",
"postal_code": "049370358",
"telephone_number": "207-453-4708",
"fax_number": "207-453-7064"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "PO BOX 358",
"city": "FAIRFIELD",
"state": "ME",
"postal_code": "049370358",
"telephone_number": "207-453-4708",
"fax_number": "207-453-7064"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHAHMORADI",
"first_name": "ANGIE",
"middle_name": "M.",
"name_prefix": "Miss",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-02-20",
"last_updated": "2025-03-28",
"certification_date": "2025-03-28",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "ME",
"license": "LC17434",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "ANGIE",
"last_name": "COLLINS",
"middle_name": "M.",
"prefix": "MISS",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Fairfield, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2025; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.