Active NPI
Devon Sanderson, LCSW
- Social Worker
- Saco, ME
National Provider Identifier
1407939770
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- LC10132
- Practice address
- 50 Moody St
Saco, ME 04072-1536 - Phone
- (207) 294-4657
- NPI assigned
- Oct 23, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Social Worker | 104100000X | LC10132 | ME | Primary |
Addresses
Primary practice location
50 Moody St
Saco, ME 04072-1536
Mailing address
147 Brackett St
Apt. 2
Portland, ME 04102-5300
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LC10132 | ME | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161561600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1407939770",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "147 BRACKETT ST",
"address_2": "APT. 2",
"city": "PORTLAND",
"state": "ME",
"postal_code": "041025300"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "50 MOODY ST",
"city": "SACO",
"state": "ME",
"postal_code": "040721536",
"telephone_number": "207-294-4657"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SANDERSON",
"first_name": "DEVON",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-23",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "ME",
"license": "LC10132",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saco, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.