Active NPI
Lisa King, LCSW
- Clinical Social Worker
- Windham, ME
National Provider Identifier
1447622899
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LC17748
- Practice address
- 778 Roosevelt TRL Ste 3B
Windham, ME 04062-5376 - Phone
- (207) 572-5441
- NPI assigned
- Oct 26, 2015
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | LC17748 | ME | Primary |
Addresses
Primary practice location
778 Roosevelt TRL Ste 3B
Windham, ME 04062-5376
Mailing address
PO Box 33
South Windham, ME 04082-0033
Phone (207) 572-5441
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200225002506 | ME | Practitioner - Clinical Social Worker | 3375970718 | Practice locations: Windham, ME |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
778 Roosevelt TRL
Suite B3
Windham, ME 04062-5376
Phone (207) 572-5441
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LC17748 | ME | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1445817600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1729641600000",
"number": "1447622899",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 33",
"city": "SOUTH WINDHAM",
"state": "ME",
"postal_code": "040820033",
"telephone_number": "207-572-5441"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "778 ROOSEVELT TRL STE 3B",
"city": "WINDHAM",
"state": "ME",
"postal_code": "040625376",
"telephone_number": "207-572-5441"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KING",
"first_name": "LISA",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-10-26",
"last_updated": "2024-10-23",
"certification_date": "2024-10-23",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "ME",
"license": "LC17748",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Windham, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.