Individual provider Active NPI

Kella River, LCSW

  • Clinical Social Worker
  • Rockland, ME
National Provider Identifier
1184190514
Registry record updated Feb 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LC17191
Practice address
91 Camden St Ste 213
Rockland, ME 04841-2459
Phone
(207) 691-1500
NPI assigned
Oct 24, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 5, 2024

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 LC17191 Primary

Addresses

Primary practice location

91 Camden St Ste 213
Rockland, ME 04841-2459

Mailing address

395 Beechwood St
Thomaston, ME 04861-3020
Phone (207) 691-1500

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
I20181213002289 ME Practitioner - Clinical Social Worker 0648515023 Practice locations: Rockland, ME

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2016
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

91 Camden St
Suite 213
Rockland, ME 04841-2459
Phone (207) 691-1500

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1540339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707091200000",
    "number": "1184190514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "395 BEECHWOOD ST",
            "city": "THOMASTON",
            "state": "ME",
            "postal_code": "048613020",
            "telephone_number": "207-691-1500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "91 CAMDEN ST STE 213",
            "city": "ROCKLAND",
            "state": "ME",
            "postal_code": "048412459",
            "telephone_number": "207-691-1500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVER",
        "first_name": "KELLA",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-10-24",
        "last_updated": "2024-02-05",
        "certification_date": "2024-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": "LC17191",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockland, ME

Sources for this page

Verify at the official NPI Registry.