Katherine C Hallissey, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LC20894 Issued in ME

Practice address

100 Foden Rd
South Portland, ME 04106-2327

Phone

(207) 523-3798

NPI assigned

Dec 18, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in ME

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Intermed, PA

  • Internal Medicine Physician
  • South Portland, ME
  • NPI 1467422733
  NPD (past)
• Mainehealth

  • Family Medicine Physician
  • Portland, ME
  • NPI 1629761978
  NPD (past)

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

{
    "created_epoch": "1576627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772582400000",
    "number": "1306484563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 GANNETT DR STE C",
            "city": "SOUTH PORTLAND",
            "state": "ME",
            "postal_code": "041065900",
            "telephone_number": "207-347-2947",
            "fax_number": "207-874-2317"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 FODEN RD",
            "city": "SOUTH PORTLAND",
            "state": "ME",
            "postal_code": "041062327",
            "telephone_number": "207-523-3798"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALLISSEY",
        "first_name": "KATHERINE",
        "middle_name": "C",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-18",
        "last_updated": "2026-03-04",
        "certification_date": "2026-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "ME",
            "license": "LC20894",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ME",
            "license": "LC20894",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Benjamin P Hagopian, M.D.
• Aimee Hahne, CCC-SLP
• Hair Matters
• Cory Hall, DPT
• Erica J Hall
• Sarah Elizabeth Hamann Hartford, LCSW, LCDC
• Jessica Kae Hancock, CSW
• Amelia M Hanley
• Joseph Hann, LMT
• Hannaford Bros Co LLC

• Clinical Social Worker in South Portland, ME
• Providers in South Portland, 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 Mar 4, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.