Sandra Emily Couch Kelly, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LC6148 Issued in ME

Practice address

410 Bridge St
Congin School
Westbrook, ME 04092-3185

Phone

(207) 854-0844

Fax

(207) 854-0846

NPI assigned

Jan 12, 2007

Sex

Female

Sole proprietor

No

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

Specialty

Clinical Social Worker

Education

Other, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Spurwink Services IncorporatedGroup PAC ID 7810026945, 87 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Spurwink Services Incorporated

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Portland, ME
  • NPI 1760507297

  ME

  Medicare reassignment Care Compare group NPD
• Spurwink Services Incorporated

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Portland, ME
  • NPI 1316945090
  NPD (past)

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

{
    "created_epoch": "1168560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1164573747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13 NORTHLEDGE TER",
            "city": "FALMOUTH",
            "state": "ME",
            "postal_code": "041052819",
            "telephone_number": "207-874-7994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 BRIDGE ST",
            "address_2": "CONGIN SCHOOL",
            "city": "WESTBROOK",
            "state": "ME",
            "postal_code": "040923185",
            "telephone_number": "207-854-0844",
            "fax_number": "207-854-0846"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COUCH KELLY",
        "first_name": "SANDRA",
        "middle_name": "EMILY",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ME",
            "license": "LC6148",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cornerstone Residential Care
• Laurel Costello, MS, RD, LD
• Caitlin Costigan, FNP-C
• Karen Coston, BCBA
• Julie Anne Cotton, LSW-C
• Sommer Cox, CAC5131
• Brittany Creamer, ATC
• Creative Works
• Brianna Crocker, BCBA
• Barbara Macdonald Crommett, O.T.

• All providers in Westbrook, ME
• Clinical Social Worker in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.

Verify at the official NPI Registry.