Individual provider Active NPI

Robyn King, LCSW

  • Clinical Social Worker
  • Waterville, ME
National Provider Identifier
1174158562
Registry record updated Mar 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LC20994 Issued in ME
Practice address
67 Eustis Pkwy
Waterville, ME 04901-5173
Phone
(207) 660-4549
Fax
(207) 660-4529
NPI assigned
Mar 6, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2022

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 LC20994 ME Primary

Addresses

Primary practice location

67 Eustis Pkwy
Waterville, ME 04901-5173

Mailing address

67 Eustis Pkwy
Waterville, ME 04901-5173
Phone (207) 660-4549

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
I20220509002251 ME Practitioner - Clinical Social Worker 4587041793 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LC20994MEMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Kennebec Valley Mental Health Center CurrentSince Mar 22, 2022 Accepting new patients

Locations

10 Caldwell Rd
Augusta, ME 04330
Phone (207) 626-3448

66 Stone St
Augusta, ME 04330
Phone (207) 626-3455

115 Mt Blue Cir
Farmington, ME 04938
Phone (207) 778-9664

5 Commerce Dr
Skowhegan, ME 04976
Phone (207) 474-8311

67 Eustis Pkwy
Waterville, ME 04901
Phone (207) 660-4549

736 Old Lewiston Rd
Winthrop, ME 04364
Phone (207) 377-8122

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1583452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648080000000",
    "number": "1174158562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "67 EUSTIS PKWY",
            "city": "WATERVILLE",
            "state": "ME",
            "postal_code": "049015173",
            "telephone_number": "207-660-4549",
            "fax_number": "607-660-4529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "67 EUSTIS PKWY",
            "city": "WATERVILLE",
            "state": "ME",
            "postal_code": "049015173",
            "telephone_number": "207-660-4549",
            "fax_number": "207-660-4529"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KING",
        "first_name": "ROBYN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-06",
        "last_updated": "2022-03-24",
        "certification_date": "2022-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ME",
            "license": "LC20994",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterville, ME

Sources for this page

Verify at the official NPI Registry.