Individual provider Active NPI

Kelsey Patrick, LCSW

  • Clinical Social Worker
  • Portland, ME
National Provider Identifier
1407336746
Registry record updated Oct 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LC19295 Issued in ME
Practice address
901 Washington Ave Ste 100
Portland, ME 04103-2842
Phone
(207) 871-1200
Fax
(207) 871-1232
NPI assigned
Aug 16, 2018
Last updated
Oct 12, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 12, 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 LC19295 ME Primary

Addresses

Primary practice location

901 Washington Ave Ste 100
Portland, ME 04103-2842

Mailing address

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

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
I20210806001856 ME Practitioner - Clinical Social Worker 3870997265 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LC19295MEMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Sweetser CurrentSince Jun 16, 2025 Accepting new patients
Spurwink Services Incorporated PastSince Jun 3, 2021 Accepting new patients

Locations

329 Bath Rd
Brunswick, ME 04011
Phone (207) 373-3012

50 Moody St
Saco, ME 04072
Phone (207) 284-5981

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1534377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697068800000",
    "number": "1407336746",
    "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": "901 WASHINGTON AVE STE 100",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041032842",
            "telephone_number": "207-871-1200",
            "fax_number": "207-871-1232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATRICK",
        "first_name": "KELSEY",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-16",
        "last_updated": "2023-10-12",
        "certification_date": "2023-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ME",
            "license": "LC19295",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, ME

Sources for this page

Verify at the official NPI Registry.