Restorative Wellness

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

RESTORATIVE WELLNESS

Practice address

16 Depot St
Windham, ME 04062-4115

Phone

(207) 749-4991

NPI assigned

Aug 19, 2020

Organization subpart

No

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

Authorized official

Name

Jessica Pao, LCSW

Title

Clinician

Phone

(207) 749-4991

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1597795200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1597795200000",
    "number": "1306458542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 DEPOT ST",
            "city": "WINDHAM",
            "state": "ME",
            "postal_code": "040624115",
            "telephone_number": "207-749-4991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 DEPOT ST",
            "city": "WINDHAM",
            "state": "ME",
            "postal_code": "040624115",
            "telephone_number": "207-749-4991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RESTORATIVE WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-19",
        "last_updated": "2020-08-19",
        "certification_date": "2020-08-19",
        "status": "A",
        "authorized_official_last_name": "PAO",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_title_or_position": "CLINICIAN",
        "authorized_official_telephone_number": "207-749-4991",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Windham, ME
• Providers in Windham, ME by specialty
• Clinical Social Worker in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2020; 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.