Individual provider Active NPI

Joshua D McQueen, LCSW

  • Clinical Social Worker
  • Portland, ME
National Provider Identifier
1366096653
Registry record updated Dec 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LC20492 Issued in ME
Practice address
62 Elm St
Portland, ME 04101-3091
Phone
(207) 871-1200
Fax
(207) 871-1232
NPI assigned
Jul 25, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LC20492 ME Primary

Addresses

Primary practice location

62 Elm St
Portland, ME 04101-3091

Mailing address

901 Washington Ave Ste 100
Portland, ME 04103-2842
Phone (207) 871-1200

Other practice location 1

22 Bramhall St
Portland, ME 04102-3175
Phone (207) 662-0111

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241219001526 ME Practitioner - Clinical Social Worker 6709313422 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LC20492MEMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Spurwink Services Incorporated CurrentSince Jul 28, 2019 Accepting new patients
Mainehealth CurrentSince Nov 6, 2024 Accepting new patients
Mainehealth Current Accepting new patients
Mainehealth CurrentSince Nov 6, 2024 Accepting new patients
Spurwink Services Incorporated PastSince Jul 28, 2019 Accepting new patients

Locations

62 Elm St
Portland, ME 04101
Phone (207) 535-2096

901 Washington Ave
Ste 100
Portland, ME 04103
Phone 20787112112145

22 Bramhall St
Portland, ME 04102
Phone (207) 662-2179

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1564012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733961600000",
    "number": "1366096653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 WASHINGTON AVE STE 100",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041032842",
            "telephone_number": "207-871-1200",
            "fax_number": "207-871-1232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "62 ELM ST",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041013091",
            "telephone_number": "207-871-1200",
            "fax_number": "207-871-1232"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "22 Bramhall St",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "ME",
            "postal_code": "041023175",
            "country_code": "US",
            "telephone_number": "207-662-0111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCQUEEN",
        "first_name": "JOSHUA",
        "middle_name": "D",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-07-25",
        "last_updated": "2024-12-12",
        "certification_date": "2024-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ME",
            "license": "LC20492",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, ME

Sources for this page

Verify at the official NPI Registry.