Active NPI
Ian C Riddell, LMSW
- Clinical Social Worker
- Westbrook, ME
National Provider Identifier
1295416840
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LC23029
- Practice address
- 123 Andover Rd
Westbrook, ME 04092-3848 - Phone
- (207) 661-6157
- NPI assigned
- Jul 27, 2023
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | LC23029 | ME | Primary |
Addresses
Primary practice location
123 Andover Rd
Westbrook, ME 04092-3848
Mailing address
123 Andover Rd
Westbrook, ME 04092-3848
Phone (207) 661-6157
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 |
|---|---|---|---|
| LC23029 | ME | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1690416000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1703635200000",
"number": "1295416840",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "123 ANDOVER RD",
"city": "WESTBROOK",
"state": "ME",
"postal_code": "040923848",
"telephone_number": "207-661-6157"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "123 ANDOVER RD",
"city": "WESTBROOK",
"state": "ME",
"postal_code": "040923848",
"telephone_number": "207-661-6157"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RIDDELL",
"first_name": "IAN",
"middle_name": "C",
"credential": "LMSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-07-27",
"last_updated": "2023-12-27",
"certification_date": "2023-12-27",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "ME",
"license": "LC23029",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Westbrook, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 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.