Individual provider Active NPI

Jamie Lee Sprague, LCSW-CC

  • Clinical Social Worker
  • Brunswick, ME
National Provider Identifier
1205505047
Registry record updated Sep 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
131684001 Issued in ME
Practice address
16 Burbank Ave
Brunswick, ME 04011-2878
Phone
(207) 631-2201
NPI assigned
Sep 7, 2021
Last updated
Sep 7, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2021

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 131684001 ME Primary

Addresses

Primary practice location

16 Burbank Ave
Brunswick, ME 04011-2878

Mailing address

16 Burbank Ave
Brunswick, ME 04011-2878
Phone (207) 631-2201

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
I20250128000651 ME Practitioner - Clinical Social Worker 0244769818 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kennebec Valley Mental Health CenterGroup PAC ID 7113829383, 68 clinicians

Practice addresses (Care Compare)

66 Stone St
Augusta, ME 04330-5227
Phone (207) 626-3455

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
131684001MEMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Kennebec Valley Mental Health Center CurrentSince Dec 19, 2024 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) 377-4121

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, 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": "1630972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630972800000",
    "number": "1205505047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 BURBANK AVE",
            "city": "BRUNSWICK",
            "state": "ME",
            "postal_code": "040112878",
            "telephone_number": "207-631-2201",
            "fax_number": "207-631-2203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 BURBANK AVE",
            "city": "BRUNSWICK",
            "state": "ME",
            "postal_code": "040112878",
            "telephone_number": "207-631-2201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPRAGUE",
        "first_name": "JAMIE",
        "middle_name": "LEE",
        "credential": "LCSW-CC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-07",
        "last_updated": "2021-09-07",
        "certification_date": "2021-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ME",
            "license": "131684001",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brunswick, ME

Sources for this page

Verify at the official NPI Registry.