Individual provider Active NPI

Phoebe S Smith, LCSW

  • Clinical Social Worker
  • Portland, ME
National Provider Identifier
1174126155
Registry record updated May 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LC21549 Issued in ME
Practice address
1577 Congress St
Portland, ME 04102-2169
Phone
(207) 662-1442
NPI assigned
Nov 20, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 2, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X MC18948 ME
Clinical Social Worker 1041C0700X LC21549 ME Primary

Addresses

Primary practice location

1577 Congress St
Portland, ME 04102-2169

Mailing address

50 Moody St
Saco, ME 04072-1536
Phone (800) 434-3000

Other practice location 1

50 Moody St
Saco, ME 04072-1536
Phone (800) 434-3000

Other names 1

  • Phoebe S Shields Former name

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221103000892 ME Practitioner - Clinical Social Worker 2466829411 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LC21549MEMDClinical Social Worker
MC18948MEMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Maine Medical Partners CurrentSince Jan 24, 2023 Accepting new patients
Maine Medical Partners CurrentSince Jan 24, 2023 Accepting new patients
Maine Medical Partners Current Accepting new patients

Locations

1577 Congress St
Ste 1
Portland, ME 04102
Phone (207) 662-1442

1577 Congress St
Portland, ME 04102
Phone (207) 662-1622

1 Harnois Ave
Ste 1A
Westbrook, ME 04092
Phone (207) 662-1360

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1605830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682985600000",
    "number": "1174126155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 MOODY ST",
            "city": "SACO",
            "state": "ME",
            "postal_code": "040721536",
            "telephone_number": "800-434-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1577 CONGRESS ST",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041022169",
            "telephone_number": "207-662-1442"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "50 Moody St",
            "address_purpose": "LOCATION",
            "city": "Saco",
            "state": "ME",
            "postal_code": "040721536",
            "country_code": "US",
            "telephone_number": "800-434-3000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "PHOEBE",
        "middle_name": "S",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-20",
        "last_updated": "2023-05-02",
        "certification_date": "2023-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ME",
            "license": "MC18948",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ME",
            "license": "LC21549",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PHOEBE",
            "last_name": "SHIELDS",
            "middle_name": "S",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Portland, ME

Sources for this page

Verify at the official NPI Registry.