Active NPI
Elaine R Goodrich, LCSW
- Clinical Social Worker
- Standish, ME
National Provider Identifier
1285659557
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LC1140
- Practice address
- 22A Ossipee Trail West
Standish, ME 04084 - Phone
- (207) 642-2098
- Fax
- (207) 642-8976
- NPI assigned
- Jul 13, 2006
- Last updated
- Jan 13, 2010
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | LC1140 | ME | Primary |
Addresses
Primary practice location
22A Ossipee Trail West
Standish, ME 04084
Mailing address
PO Box 824
Standish, ME 04084-0824
Phone (207) 642-2098
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 003850 | Other | ME | ANTHEM PIN |
| 1036508 | Other | ME | CIGNA PIN |
| 004846 | Other | ME | TRICARE AND HARVARD PILGR |
| 5298100 | Other | ME | AETNA BEHAVIORAL HEALTH |
| 149250 (MHS) | Other | ME | VALUE OPTIONS PIN |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LC1140 | ME | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152748800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1263340800000",
"number": "1285659557",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 824",
"city": "STANDISH",
"state": "ME",
"postal_code": "040840824",
"telephone_number": "207-642-2098",
"fax_number": "207-642-8976"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "22A OSSIPEE TRAIL WEST",
"city": "STANDISH",
"state": "ME",
"postal_code": "04084",
"telephone_number": "207-642-2098",
"fax_number": "207-642-8976"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOODRICH",
"first_name": "ELAINE",
"middle_name": "R",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-07-13",
"last_updated": "2010-01-13",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "ME",
"license": "LC1140",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM PIN",
"identifier": "003850",
"state": "ME"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA PIN",
"identifier": "1036508",
"state": "ME"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TRICARE AND HARVARD PILGR",
"identifier": "004846",
"state": "ME"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA BEHAVIORAL HEALTH",
"identifier": "5298100",
"state": "ME"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VALUE OPTIONS PIN",
"identifier": "149250 (MHS)",
"state": "ME"
}
],
"endpoints": [],
"other_names": []
}Other providers in Standish, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.