Active NPI
Stephanie Ann Michaud
- Social Worker
- Waterville, ME
National Provider Identifier
1265277875
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- MC23602
- Practice address
- 67 Eustis Pkwy
Waterville, ME 04901-5173 - Phone
- (207) 873-2136
- Fax
- (207) 660-4529
- NPI assigned
- Jun 26, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | MC23602 | ME | Primary |
Addresses
Primary practice location
67 Eustis Pkwy
Waterville, ME 04901-5173
Mailing address
67 Eustis Pkwy
Waterville, ME 04901-5173
Phone (207) 873-2136
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
| License | State | Type | Specialty |
|---|---|---|---|
| MC23602 | ME | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1719360000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1720396800000",
"number": "1265277875",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "67 EUSTIS PKWY",
"city": "WATERVILLE",
"state": "ME",
"postal_code": "049015173",
"telephone_number": "207-873-2136",
"fax_number": "207-660-4529"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "67 EUSTIS PKWY",
"city": "WATERVILLE",
"state": "ME",
"postal_code": "049015173",
"telephone_number": "207-873-2136",
"fax_number": "207-660-4529"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MICHAUD",
"first_name": "STEPHANIE",
"middle_name": "ANN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-06-26",
"last_updated": "2024-07-08",
"certification_date": "2024-07-01",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "ME",
"license": "MC23602",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Waterville, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.