Individual provider Active NPI

Nicole Pietrini Richman, LCSW

  • Clinical Social Worker
  • Gorham, ME
National Provider Identifier
1386603363
Registry record updated Dec 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LC5065 Issued in ME
Practice address
88 State St Ste 203
Gorham, ME 04038-1173
Phone
(207) 839-3535
Fax
(207) 222-4013
NPI assigned
Mar 20, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 21, 2021

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 LC5065 ME Primary

Addresses

Primary practice location

88 State St Ste 203
Gorham, ME 04038-1173

Mailing address

15 Cedar LN
Raymond, ME 04071-6381
Phone (207) 468-8108

Other identifiers 2

IdentifierTypeStateIssuer
413848OtherMEAETNA
047034OtherMEANTHEM

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://nicole-richman.clientsecure.me/ Direct

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
I20040915001074 ME Practitioner - Clinical Social Worker 0446227656 Practice locations: Raymond, ME

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1288 Roosevelt TRL
Suite 5B
Raymond, ME 04071-6660
Phone 20783935351

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LC5065MEMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Transitions Counseling, Inc. Past 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": "1142812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640044800000",
    "number": "1386603363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 CEDAR LN",
            "city": "RAYMOND",
            "state": "ME",
            "postal_code": "040716381",
            "telephone_number": "207-468-8108",
            "fax_number": "207-222-4013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "88 STATE ST STE 203",
            "city": "GORHAM",
            "state": "ME",
            "postal_code": "040381173",
            "telephone_number": "207-839-3535",
            "fax_number": "207-222-4013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICHMAN",
        "first_name": "NICOLE",
        "middle_name": "PIETRINI",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-03-20",
        "last_updated": "2021-12-21",
        "certification_date": "2021-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ME",
            "license": "LC5065",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "413848",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "047034",
            "state": "ME"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://nicole-richman.clientsecure.me/",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "88 State St Ste 203",
            "city": "Gorham",
            "state": "ME",
            "country_code": "US",
            "postal_code": "040381173",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Gorham, ME

Sources for this page

Verify at the official NPI Registry.