Individual provider Active NPI

Ruth Sickel Emmett, LCSW

  • Clinical Social Worker
  • Bangor, ME
National Provider Identifier
1447487475
Registry record updated May 16, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LC12793 Issued in ME
Practice address
360 Harlow St.
Bangor, ME 04401
Phone
(207) 470-7090
Fax
(207) 470-7094
NPI assigned
Jun 17, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 16, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X MC11136 ME
Clinical Social Worker 1041C0700X LC12793 ME Primary

Addresses

Primary practice location

360 Harlow St.
Bangor, ME 04401

Mailing address

360 Harlow Street
Bangor, ME 04401
Phone (207) 470-7090

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
I20110808000004 ME Practitioner - Clinical Social Worker 7315116423 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Northeast Occupational Exchange IncGroup PAC ID 5092709345, 4 clinicians

Practice addresses (Care Compare)

9 Main St
Suite a
Lincoln, ME 04457-1216
Phone (207) 942-3816

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MC11136MEMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Occupational Exchange, Inc CurrentSince Jun 1, 2011 Accepting new patients

Locations

444 Stillwater Ave
Ste 210
Bangor, ME 04401
Phone (207) 907-4311

9 Main St
Lincoln, ME 04457
Phone (207) 521-8911

9 Main St
Ste A
Lincoln, ME 04457

442 Moosehead Trl
Newport, ME 04953
Phone (207) 368-2072

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": "1245196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1305504000000",
    "number": "1447487475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 HARLOW STREET",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "04401",
            "telephone_number": "207-470-7090",
            "fax_number": "207-470-7094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 HARLOW ST.",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "04401",
            "telephone_number": "207-470-7090",
            "fax_number": "207-470-7094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EMMETT",
        "first_name": "RUTH",
        "middle_name": "SICKEL",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-17",
        "last_updated": "2011-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ME",
            "license": "MC11136",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ME",
            "license": "LC12793",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bangor, ME

Sources for this page

Verify at the official NPI Registry.