Individual provider Active NPI

Christine C. Kimball, LCSW

  • Clinical Social Worker
  • Damariscotta, ME
National Provider Identifier
1447215595
Registry record updated Mar 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LC6208 Issued in ME
Practice address
79 Schooner St
Damariscotta, ME 04543-4051
Phone
(207) 294-4657
Fax
(207) 294-4649
NPI assigned
Apr 20, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 4, 2013

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 LC6208 ME Primary

Addresses

Primary practice location

79 Schooner St
Damariscotta, ME 04543-4051

Mailing address

Box 118
Whitefield, ME 04353
Phone (207) 549-5622

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
I20051024001049 ME Practitioner - Clinical Social Worker 5092732503 Practice locations: Newcastle, ME

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

39 River Rd
Newcastle, ME 04553-3802
Phone (207) 242-3742

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LC6208MEMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Possibilities Counseling Services, Inc. Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1145491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1362355200000",
    "number": "1447215595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "BOX 118",
            "city": "WHITEFIELD",
            "state": "ME",
            "postal_code": "04353",
            "telephone_number": "207-549-5622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "79 SCHOONER ST",
            "city": "DAMARISCOTTA",
            "state": "ME",
            "postal_code": "045434051",
            "telephone_number": "207-294-4657",
            "fax_number": "207-294-4649"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIMBALL",
        "first_name": "CHRISTINE",
        "middle_name": "C.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-04-20",
        "last_updated": "2013-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ME",
            "license": "LC6208",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Damariscotta, ME

Sources for this page

Verify at the official NPI Registry.