Individual provider Active NPI

Cindy Marie Barker, MSW-CC

  • Clinical Social Worker
  • Caribou, ME
National Provider Identifier
1174879985
Registry record updated Oct 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LC15777 Issued in ME
Practice address
27 Birdseye Ave
Caribou, ME 04736-1620
Phone
(207) 492-1653
Fax
(207) 492-1633
NPI assigned
Jul 30, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X MC13668 ME
Clinical Social Worker 1041C0700X LC15777 ME Primary

Addresses

Primary practice location

27 Birdseye Ave
Caribou, ME 04736-1620

Mailing address

PO Box 509
Presque Isle, ME 04769-0509
Phone (207) 764-6825

Other practice location 1

147 Academy St
Presque Isle, ME 04769-3101
Phone (207) 764-6825

Other identifiers 1

IdentifierTypeStateIssuer
1174879985MedicaidME

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
I20190212000871 ME Practitioner - Clinical Social Worker 7113265489 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Life by Design, PAGroup PAC ID 9032188909, 6 clinicians

Practice addresses (Care Compare)

147 Academy St
Presque Isle, ME 04769-3101
Phone (207) 764-6825

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MC13668MEMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Life by Design, PA Clinical CurrentSince Jan 8, 2019 Accepting new patients
Life by Design Past Accepting new patients
Carlos G. Otis Health Care Center Inc. PastSince Jan 8, 2019 Accepting new patients

Locations

27 Birdseye Ave
Caribou, ME 04736
Phone (207) 492-1653

18 High St
Houlton, ME 04730
Phone (207) 532-9660

147 Academy St
Presque Isle, ME 04769
Phone (207) 532-9660

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": "1343606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570060800000",
    "number": "1174879985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 509",
            "city": "PRESQUE ISLE",
            "state": "ME",
            "postal_code": "047690509",
            "telephone_number": "207-764-6825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27 BIRDSEYE AVE",
            "city": "CARIBOU",
            "state": "ME",
            "postal_code": "047361620",
            "telephone_number": "207-492-1653",
            "fax_number": "207-492-1633"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "147 Academy St",
            "address_purpose": "LOCATION",
            "city": "Presque Isle",
            "state": "ME",
            "postal_code": "047693101",
            "country_code": "US",
            "telephone_number": "207-764-6825",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BARKER",
        "first_name": "CINDY",
        "middle_name": "MARIE",
        "credential": "MSW-CC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-30",
        "last_updated": "2019-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "ME",
            "license": "MC13668",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ME",
            "license": "LC15777",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1174879985",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Caribou, ME

Sources for this page

Verify at the official NPI Registry.