Individual provider Active NPI

Decha Bailey, LCSW

  • Clinical Social Worker
  • Brewer, ME
National Provider Identifier
1184859522
Registry record updated Jan 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LC13011 Issued in ME
Practice address
17 Doughty Dr Ste 102
Brewer, ME 04412-2278
Phone
(207) 263-0134
NPI assigned
May 28, 2009
Last updated
Jan 25, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2023

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 LC13011 ME Primary

Addresses

Primary practice location

17 Doughty Dr Ste 102
Brewer, ME 04412-2278

Mailing address

10 Carroll CT
Brewer, ME 04412-5323
Phone (207) 992-6759

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
I20110524000238 ME Practitioner - Clinical Social Worker 0840476008 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Acadia Hospital Corp CurrentSince Apr 4, 2011 Accepting new patients
Eastern Maine Medical Center CurrentSince Apr 4, 2011 Accepting new patients
Eastern Maine Medical Center CurrentSince Apr 4, 2011 Accepting new patients
Health Affiliates Maine, LLC CurrentSince May 26, 2019 Accepting new patients

Locations

306 Rodman Rd
Auburn, ME 04210
Phone (207) 333-3278

268 Stillwater Ave
Bangor, ME 04401
Phone (207) 973-6470

489 State St
Bangor, ME 04401
Phone (207) 973-8837

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1243468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674604800000",
    "number": "1184859522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 CARROLL CT",
            "city": "BREWER",
            "state": "ME",
            "postal_code": "044125323",
            "telephone_number": "207-992-6759"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 DOUGHTY DR STE 102",
            "city": "BREWER",
            "state": "ME",
            "postal_code": "044122278",
            "telephone_number": "207-263-0134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAILEY",
        "first_name": "DECHA",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-05-28",
        "last_updated": "2023-01-25",
        "certification_date": "2023-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ME",
            "license": "LC13011",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brewer, ME

Sources for this page

Verify at the official NPI Registry.