Active NPI
Ivelisse Slaven, LCSW
- Clinical Social Worker
- Augusta, ME
National Provider Identifier
1467409615
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LC8692
- Practice address
- 1 VA Ctr
Augusta, ME 04330-6795 - Phone
- (207) 623-8411
- NPI assigned
- May 30, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | LC8692 | ME | |
| Clinical Social Worker | 1041C0700X | LC8692 | ME | Primary |
Addresses
Primary practice location
1 VA Ctr
Augusta, ME 04330-6795
Mailing address
1 VA Ctr
Augusta, ME 04330-6795
Phone (207) 623-8411
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 098304 | Other | ME | ANTHEM LEGACY NUMBER |
| 294220099 | Medicaid | ME |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LC8692 | ME | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Northeast Occupational Exchange, Inc | Social Worker | 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": "1148947200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1598313600000",
"number": "1467409615",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 VA CTR",
"city": "AUGUSTA",
"state": "ME",
"postal_code": "043306795",
"telephone_number": "207-623-8411"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 VA CTR",
"city": "AUGUSTA",
"state": "ME",
"postal_code": "043306795",
"telephone_number": "207-623-8411"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SLAVEN",
"first_name": "IVELISSE",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-05-30",
"last_updated": "2020-08-25",
"certification_date": "2020-08-25",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "ME",
"license": "LC8692",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "ME",
"license": "LC8692",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM LEGACY NUMBER",
"identifier": "098304",
"state": "ME"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "294220099",
"state": "ME"
}
],
"endpoints": [],
"other_names": []
}Other providers in Augusta, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2020; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.