Individual provider Active NPI

Samantha Maristany, LCSW LADC CCS LICSW

  • Clinical Social Worker
  • South Portland, ME
National Provider Identifier
1255931697
Registry record updated Nov 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LC21139 Issued in ME
Practice address
725 Main St
South Portland, ME 04106-5424
Phone
(207) 331-4371
NPI assigned
Oct 26, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LC21139 ME Primary
Addiction (Substance Use Disorder) Counselor 101YA0400X CCS8543 ME
Addiction (Substance Use Disorder) Counselor 101YA0400X LC8009 ME
Clinical Social Worker 1041C0700X LICSW126257 MA

Addresses

Primary practice location

725 Main St
South Portland, ME 04106-5424

Mailing address

725 Main St
South Portland, ME 04106-5424
Phone (207) 331-4371

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
CCS8543MEMDAddiction (Substance Use Disorder) Counselor
LC8009MEMDAddiction (Substance Use Disorder) Counselor
LICSW126257MAMDClinical Social Worker
LC21139MEMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
For Me, LLC CurrentSince Sep 1, 2023 Accepting new patients
Day One Counselor PastSince Nov 1, 2020 Accepting new patients

Locations

725 Main St
South Portland, ME 04106
Phone (207) 331-4371

Organizations & group practices 2

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": "1603670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700092800000",
    "number": "1255931697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "725 MAIN ST",
            "city": "SOUTH PORTLAND",
            "state": "ME",
            "postal_code": "041065424",
            "telephone_number": "207-331-4371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 MAIN ST",
            "city": "SOUTH PORTLAND",
            "state": "ME",
            "postal_code": "041065424",
            "telephone_number": "207-331-4371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARISTANY",
        "first_name": "SAMANTHA",
        "name_prefix": "Dr.",
        "credential": "LCSW LADC CCS LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-26",
        "last_updated": "2023-11-16",
        "certification_date": "2023-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ME",
            "license": "LC21139",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "ME",
            "license": "CCS8543",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "ME",
            "license": "LC8009",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "LICSW126257",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Portland, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.