Robert Bennett Jr., LCSW
Individual provider Active NPI Clinical Social Worker · Portland, ME
NPI 1316772155 · NPPES record last updated Sep 3, 2024
Key facts
- NPI
- 1316772155
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- LC23946 (ME)
- Practice address
- 193 Clark St Apt 2
Portland, ME 04102-3834 - Phone
- (207) 252-2124
- NPI assigned
- Sep 3, 2024
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Clinical Social Worker
- Education
- Other, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
193 Clark St
Apt 2
Portland, ME 04102-3834
Phone (207) 252-2124
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in ME
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250528001353 | ME | Practitioner - Clinical Social Worker | 8224557764 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ethier-Bennett LCSW, LLC | Clinical | Current |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | LC23946 | ME | Yes |
Addresses
Primary practice location
193 Clark St Apt 2
Portland, ME 04102-3834
Mailing address
193 Clark St Apt 2
Portland, ME 04102-3834
Phone (207) 252-2124
Other providers in Portland, ME
- Jean C Bennett
- Johanna Kathleen Bennett
- Kathleen E Bennett
- Mary Bennett
- Michael Bennett
- Shannon M. Bennett
- Theresa L Bennett
- Tracy W Bennett
- David Arthur Benoit Sr.
- Lynne A Benoit
All providers in Portland, ME · Clinical Social Worker in Maine
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 3, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.