Individual provider Active NPI

Max James Louison-Semrow, LCSW / LICSW

  • Clinical Social Worker
  • Scarborough, ME
National Provider Identifier
1386411775
Registry record updated Dec 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LC22078 Issued in ME
Practice address
144 US Route 1
Scarborough, ME 04074-7219
Phone
(207) 396-7606
Fax
(207) 819-6802
NPI assigned
Dec 6, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LC22078 ME Primary
Clinical Social Worker 1041C0700X LICSW126 MA

Addresses

Primary practice location

144 US Route 1
Scarborough, ME 04074-7219

Mailing address

144 US Route 1
Scarborough, ME 04074-7219
Phone (207) 396-7606

Other practice location 1

27 Industrial Ave Ste 101
Sanford, ME 04073-5846
Phone (207) 396-7606

Other practice location 2

310 Poland Range Rd
Pownal, ME 04069-6206
Phone (207) 200-4351

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20241206000338 ME Practitioner - Clinical Social Worker 1355877986 Practice locations: Pownal, ME
I20250103001432 ME Practitioner - Clinical Social Worker 1355877986 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

Pownal, ME 04069
Phone (207) 200-4351

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LICSW126MAMDClinical Social Worker
LC22078MEMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Max Louison-Semrow LCSW, LLC Clinical CurrentSince Nov 18, 2024 Accepting new patients

Organizations & group practices 1

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": "1701820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733443200000",
    "number": "1386411775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "144 US ROUTE 1",
            "city": "SCARBOROUGH",
            "state": "ME",
            "postal_code": "040747219",
            "telephone_number": "207-396-7606",
            "fax_number": "207-819-6802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "144 US ROUTE 1",
            "city": "SCARBOROUGH",
            "state": "ME",
            "postal_code": "040747219",
            "telephone_number": "207-396-7606",
            "fax_number": "207-819-6802"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "27 Industrial Ave Ste 101",
            "address_purpose": "LOCATION",
            "city": "Sanford",
            "state": "ME",
            "postal_code": "040735846",
            "country_code": "US",
            "telephone_number": "207-396-7606",
            "fax_number": "207-819-6802",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "310 Poland Range Rd",
            "address_purpose": "LOCATION",
            "city": "Pownal",
            "state": "ME",
            "postal_code": "040696206",
            "country_code": "US",
            "telephone_number": "207-200-4351",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LOUISON-SEMROW",
        "first_name": "MAX",
        "middle_name": "JAMES",
        "credential": "LCSW / LICSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-12-06",
        "last_updated": "2024-12-06",
        "certification_date": "2024-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ME",
            "license": "LC22078",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "LICSW126",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scarborough, ME

Sources for this page

Verify at the official NPI Registry.