Individual provider Active NPI

Anne T. Lafontaine

  • Clinical Social Worker
  • Portland, ME
National Provider Identifier
1164757167
Registry record updated Aug 26, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
MC11637 Issued in ME
Practice address
66 State St
Portland, ME 04101-3751
Phone
(207) 871-7431
Fax
(207) 871-7457
NPI assigned
Oct 8, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X MC11637 ME Primary

Addresses

Primary practice location

66 State St
Portland, ME 04101-3751

Mailing address

66 State St
P. O. Box 797
Portland, ME 04101-3751
Phone (207) 871-7431

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
MC11637MEMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1254960000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1282780800000",
    "number": "1164757167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "66 STATE ST",
            "address_2": "P. O. BOX 797",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041013751",
            "telephone_number": "207-871-7431",
            "fax_number": "207-871-7457"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "66 STATE ST",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041013751",
            "telephone_number": "207-871-7431",
            "fax_number": "207-871-7457"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAFONTAINE",
        "first_name": "ANNE",
        "middle_name": "T.",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-10-08",
        "last_updated": "2010-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ME",
            "license": "MC11637",
            "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 Aug 26, 2010; 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.