Individual provider Active NPI

Lori Hobart, LICSW, LCSW

  • Clinical Social Worker
  • Phippsburg, ME
National Provider Identifier
1407954688
Registry record updated Oct 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
12050 Issued in ME
Practice address
76 The Blvd
Phippsburg, ME 04562-4364
Phone
(207) 577-7078
Fax
(978) 383-0252
NPI assigned
Sep 20, 2006
Last updated
Oct 18, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 18, 2024

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 12050 ME Primary

Addresses

Primary practice location

76 The Blvd
Phippsburg, ME 04562-4364

Mailing address

10 State Rd # 223
Bath, ME 04530-6017
Phone (207) 577-7078

Other practice location 1

5316 Yacht Haven Grande
Suite N-104 Unit 1050
ST Thomas, VI 00802
Phone (207) 577-7078

Other practice location 2

45 Walden St
Concord, MA 01742-2533
Phone (207) 577-7078

Other identifiers 1

IdentifierTypeStateIssuer
P08205OtherMABCBSMA

Other names 1

  • Lori Kidger Former name

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
I20141011000035 ME Practitioner - Clinical Social Worker 8426949934 Practice locations: Phippsburg, ME

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Boston University School of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

76 The Blvd
Phippsburg, ME 04562-4364
Phone (207) 577-7078

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729209600000",
    "number": "1407954688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 STATE RD # 223",
            "city": "BATH",
            "state": "ME",
            "postal_code": "045306017",
            "telephone_number": "207-577-7078",
            "fax_number": "978-383-0252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "76 THE BLVD",
            "city": "PHIPPSBURG",
            "state": "ME",
            "postal_code": "045624364",
            "telephone_number": "207-577-7078",
            "fax_number": "978-383-0252"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5316 Yacht Haven Grande",
            "address_2": "Suite N-104 Unit 1050",
            "address_purpose": "LOCATION",
            "city": "ST Thomas",
            "state": "VI",
            "postal_code": "00802",
            "country_code": "US",
            "telephone_number": "207-577-7078",
            "fax_number": "978-383-0252",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "45 Walden St",
            "address_purpose": "LOCATION",
            "city": "Concord",
            "state": "MA",
            "postal_code": "017422533",
            "country_code": "US",
            "telephone_number": "207-577-7078",
            "fax_number": "978-383-0252",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HOBART",
        "first_name": "LORI",
        "credential": "LICSW, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-20",
        "last_updated": "2024-10-18",
        "certification_date": "2024-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ME",
            "license": "12050",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSMA",
            "identifier": "P08205",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LORI",
            "last_name": "KIDGER",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Phippsburg, ME

Sources for this page

Verify at the official NPI Registry.