Active NPI
Kay I Landry, LCSW
- Clinical Social Worker
- Augusta, ME
National Provider Identifier
1316195720
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LC1136
- Practice address
- 99 Western Ave
Suite # 12
Augusta, ME 04330-7229 - Phone
- (207) 622-0026
- Fax
- (207) 622-0002
- NPI assigned
- Aug 28, 2008
- Last updated
- Apr 30, 2009
- 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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | LC1136 | ME | Primary |
Addresses
Primary practice location
99 Western Ave
Suite # 12
Augusta, ME 04330-7229
Mailing address
99 Western Ave
Suite #12
Augusta, ME 04330-7229
Phone (207) 622-0026
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 121210000 | Medicaid | ME |
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 |
|---|---|---|---|
| LC1136 | ME | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1219881600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1241049600000",
"number": "1316195720",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "99 WESTERN AVE",
"address_2": "SUITE #12",
"city": "AUGUSTA",
"state": "ME",
"postal_code": "043307229",
"telephone_number": "207-622-0026",
"fax_number": "207-622-0026"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "99 WESTERN AVE",
"address_2": "SUITE # 12",
"city": "AUGUSTA",
"state": "ME",
"postal_code": "043307229",
"telephone_number": "207-622-0026",
"fax_number": "207-622-0002"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LANDRY",
"first_name": "KAY",
"middle_name": "I",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-08-28",
"last_updated": "2009-04-30",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "ME",
"license": "LC1136",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "121210000",
"state": "ME"
}
],
"endpoints": [],
"other_names": []
}Other providers in Augusta, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.