Active NPI
Amy M Burrell, LCPC
- Social Worker
- Ellsworth, ME
National Provider Identifier
1346454758
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- CC3230
- Practice address
- 16 Kidspeace Way
Ellsworth, ME 04605-0787 - Phone
- (207) 667-0909
- Fax
- (207) 667-6348
- NPI assigned
- May 9, 2007
- Last updated
- Feb 19, 2020
- 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 | CC3230 | ME | Primary |
Addresses
Primary practice location
16 Kidspeace Way
Ellsworth, ME 04605-0787
Mailing address
PO Box 787
Ellsworth, ME 04605-0787
Phone (207) 667-0909
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 432560699 | Medicaid | ME |
Medicare participation
Medicare enrollment files- 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250604002896 | ME | Practitioner - Mental Health Counselor | 5991214595 | Practice locations: Ellsworth, ME |
Care Compare profile
Medicare Care Compare- Specialty
- Mental Health Counselor
- Education
- Other, 2004
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
71 Oak St
Suite 2B
Ellsworth, ME 04605-1641
Phone (207) 288-8686
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178668800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1582070400000",
"number": "1346454758",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 787",
"city": "ELLSWORTH",
"state": "ME",
"postal_code": "046050787",
"telephone_number": "207-667-0909",
"fax_number": "207-667-6348"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16 KIDSPEACE WAY",
"city": "ELLSWORTH",
"state": "ME",
"postal_code": "046050787",
"telephone_number": "207-667-0909",
"fax_number": "207-667-6348"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BURRELL",
"first_name": "AMY",
"middle_name": "M",
"name_prefix": "Mrs.",
"credential": "LCPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-09",
"last_updated": "2020-02-19",
"certification_date": "2020-02-19",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "ME",
"license": "CC3230",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "432560699",
"state": "ME"
}
],
"endpoints": [],
"other_names": []
}Other providers in Ellsworth, ME
- Bucksport Regional Health Center
- Bucksport Regional Health Center
- Kimberly Ann Burgess, LSW-C, BHP
- Brittany Marie Burke, RN
- Ashley Burns, LCPC-C
- Elizabeth Diane Byard, RNC FNP
- William C Caddoo, DMD
- Mary M Callow, MS, CCC-SLP
- Jennifer Cammack
- Caring Hands of Maine (Caring Hands of Maine Dental Center)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2020; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.