Evergreen Psychotherapy

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

EVERGREEN PSYCHOTHERAPY

Practice address

844 Stevens Ave
Portland, ME 04103-2676

Phone

(508) 243-3580

NPI assigned

Oct 18, 2024

Last updated

Nov 15, 2024By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Jaime Mastrorio, LCSWNPI 1679083604

Title

Owner / LCSW

Phone

(508) 243-3580

Specialties & licenses 1

Addresses

Other names 1

• Jaime Mastrorio LCSW Other name

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jaime Mastrorio, LCSW

  • Clinical Social Worker
  • Portland, ME
  • NPI 1679083604
  Authorized official Same address or phone

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

{
    "created_epoch": "1729209600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731628800000",
    "number": "1427879840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "844 STEVENS AVE",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041032676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "844 STEVENS AVE",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041032676",
            "telephone_number": "508-243-3580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVERGREEN PSYCHOTHERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-18",
        "last_updated": "2024-11-15",
        "certification_date": "2024-11-15",
        "status": "A",
        "authorized_official_last_name": "MASTRORIO",
        "authorized_official_first_name": "JAIME",
        "authorized_official_title_or_position": "OWNER / LCSW",
        "authorized_official_telephone_number": "508-243-3580",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jaime Mastrorio LCSW",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Jaime Mastrorio LCSW",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Sonja R Evans, DMD
• Val Alexander Evans, DO
• Everest Care LLC
• Haley Dawn Everett, DC
• Evergreen Physical Therapy & Care
• Evergreen Recovery LLC
• Evergreen Recovery LLC
• Carole Ewald, LCSW
• Marissa Exchange
• Eyecare Medical Group

• Clinical Social Worker in Portland, ME
• Providers in Portland, ME by specialty
• Clinical Social Worker in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.