Individual provider Active NPI

Kimm Marie Cooney, LCSW

  • Clinical Social Worker
  • Skowhegan, ME
National Provider Identifier
1407985245
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LC9996 Issued in ME
Practice address
25 Pleasant St
Skowhegan, ME 04976-1229
Phone
(207) 474-6115
NPI assigned
Mar 5, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 LC9996 ME Primary

Addresses

Primary practice location

25 Pleasant St
Skowhegan, ME 04976-1229

Mailing address

37 Bennett Ave
Skowhegan, ME 04976-1213
Phone (207) 474-0401

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
I20150921001815 ME Practitioner - Clinical Social Worker 0547577710 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
MainehealthGroup PAC ID 7517860588, 2,616 clinicians

Practice addresses (Care Compare)

108 Centre St
Bath, ME 04530-2550

22 Bramhall St
Portland, ME 04102-3134
Phone (207) 885-9905

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
97.93 of 100Reported as apm
Quality
83.31
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LC9996MEMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Mainehealth CurrentSince Dec 1, 2020 Accepting new patients
Mainehealth CurrentSince Dec 1, 2020 Accepting new patients
Acadia Hospital Corp CurrentSince Sep 1, 2018 Accepting new patients
Mainehealth Current Accepting new patients

Locations

268 Stillwater Ave
Bangor, ME 04401
Phone (207) 973-6470

123 Medical Center Dr
Brunswick, ME 04011
Phone (207) 373-6800

329 Maine St
Ste A200
Brunswick, ME 04011
Phone (207) 373-4700

22 Bramhall St
Portland, ME 04102
Phone (207) 662-2179

1 Wellness Way
Ste A
Topsham, ME 04086
Phone (207) 386-1808

Organizations & group practices 4

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1173052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1407985245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "37 BENNETT AVE",
            "city": "SKOWHEGAN",
            "state": "ME",
            "postal_code": "049761213",
            "telephone_number": "207-474-0401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 PLEASANT ST",
            "city": "SKOWHEGAN",
            "state": "ME",
            "postal_code": "049761229",
            "telephone_number": "207-474-6115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COONEY",
        "first_name": "KIMM",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ME",
            "license": "LC9996",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Skowhegan, ME

Sources for this page

Verify at the official NPI Registry.