Active NPI
Karen Amanda Degrandpre, LMSW-CC
- Social Worker
- Scarborough, ME
National Provider Identifier
1316130511
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- MC11270
- Practice address
- 100 Campus Dr
Unit 107
Scarborough, ME 04074-9692 - Phone
- (207) 885-7565
- Fax
- (207) 885-7577
- NPI assigned
- Aug 21, 2007
- 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 | MC11270 | ME | Primary |
Addresses
Primary practice location
100 Campus Dr
Unit 107
Scarborough, ME 04074-9692
Mailing address
39 Wallace Ave
South Portland, ME 04106-6143
Phone (207) 761-0650
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 |
|---|---|---|---|
| MC11270 | ME | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1187654400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1187654400000",
"number": "1316130511",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "39 WALLACE AVE",
"city": "SOUTH PORTLAND",
"state": "ME",
"postal_code": "041066143",
"telephone_number": "207-761-0650",
"fax_number": "207-761-8198"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 CAMPUS DR",
"address_2": "UNIT 107",
"city": "SCARBOROUGH",
"state": "ME",
"postal_code": "040749692",
"telephone_number": "207-885-7565",
"fax_number": "207-885-7577"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEGRANDPRE",
"first_name": "KAREN",
"middle_name": "AMANDA",
"credential": "LMSW-CC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-08-21",
"last_updated": "2007-08-21",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "ME",
"license": "MC11270",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Scarborough, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.