Individual provider Active NPI

Thomas Evers Glendon, L.C.S.W.

  • Clinical Social Worker
  • Portland, ME
National Provider Identifier
1396704979
Registry record updated Oct 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LC6973 Issued in ME
Practice address
411 Congress St
Portland, ME 04101-3505
Phone
(207) 831-6260
Fax
(207) 681-5385
NPI assigned
Mar 21, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 13, 2023

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 LC6973 ME Primary

Addresses

Primary practice location

411 Congress St
Portland, ME 04101-3505

Mailing address

615 Congress St Ste 601F
Portland, ME 04101-3343
Phone (207) 831-6260

Other identifiers 1

IdentifierTypeStateIssuer
047825OtherANTHEM PROVIDER ID

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
I20040623000073 ME Practitioner - Clinical Social Worker 9436134467 Practice locations: Portland, ME

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

411 Congress St
Portland, ME 04101-3505
Phone (207) 831-6260

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

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": "1142899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697155200000",
    "number": "1396704979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 CONGRESS ST STE 601F",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041013343",
            "telephone_number": "207-831-6260",
            "fax_number": "207-681-5385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 CONGRESS ST",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041013505",
            "telephone_number": "207-831-6260",
            "fax_number": "207-681-5385"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLENDON",
        "first_name": "THOMAS",
        "middle_name": "EVERS",
        "name_prefix": "Mr.",
        "credential": "L.C.S.W.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-21",
        "last_updated": "2023-10-13",
        "certification_date": "2021-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ME",
            "license": "LC6973",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PROVIDER ID",
            "identifier": "047825",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, ME

Sources for this page

Verify at the official NPI Registry.