Active NPI
Thomas Duane Hansen, LCSW
- Clinical Social Worker
- Ellsworth, ME
National Provider Identifier
1396806345
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 1079
- Practice address
- 210 Main St
Suite 2
Ellsworth, ME 04605-1949 - Phone
- (207) 664-0097
- Fax
- (207) 664-0097
- NPI assigned
- Dec 13, 2006
- Last updated
- Mar 8, 2013
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 1079 | ME | Primary |
Addresses
Primary practice location
210 Main St
Suite 2
Ellsworth, ME 04605-1949
Mailing address
P.O. Box 1582
Ellsworth, ME 04605-1582
Phone (207) 664-0097
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 026657 | Other | ME | BLUE CROSS BLUE SHIELD |
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 |
|---|---|---|---|---|
| I20050304000016 | ME | Practitioner - Clinical Social Worker | 3072567874 | Practice locations: Ellsworth, ME |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 1975
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
210 Main St
Ellsworth, ME 04605-1950
Phone (207) 664-0097
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LC1079 | ME | MD | Counselor |
| 1079 | ME | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165968000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1362700800000",
"number": "1396806345",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "P.O. BOX 1582",
"city": "ELLSWORTH",
"state": "ME",
"postal_code": "046051582",
"telephone_number": "207-664-0097",
"fax_number": "207-664-0097"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "210 MAIN ST",
"address_2": "SUITE 2",
"city": "ELLSWORTH",
"state": "ME",
"postal_code": "046051949",
"telephone_number": "207-664-0097",
"fax_number": "207-664-0097"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HANSEN",
"first_name": "THOMAS",
"middle_name": "DUANE",
"name_prefix": "Dr.",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-12-13",
"last_updated": "2013-03-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "ME",
"license": "1079",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "026657",
"state": "ME"
}
],
"endpoints": [],
"other_names": []
}Other providers in Ellsworth, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2013; 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.