Individual provider Active NPI

Claire Koenig, LCSW

  • Clinical Social Worker
  • Waterville, ME
National Provider Identifier
1467472548
Registry record updated May 20, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LC10224 Issued in ME
Practice address
67 Eustis Pkwy
Waterville, ME 04901-5173
Phone
(207) 873-2136
Fax
(207) 872-4522
NPI assigned
Jul 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2016

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 LC10224 ME Primary

Addresses

Primary practice location

67 Eustis Pkwy
Waterville, ME 04901-5173

Mailing address

67 Eustis Pkwy
Waterville, ME 04901-5173
Phone (207) 873-2136

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
I20060424000036 ME Practitioner - Clinical Social Worker 3476562455 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kennebec Valley Mental Health CenterGroup PAC ID 7113829383, 68 clinicians

Practice addresses (Care Compare)

67 Eustis Pkwy
Waterville, ME 04901-5173
Phone (207) 873-2136

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Mainehealth CurrentSince Nov 1, 2018 Accepting new patients
Mainehealth CurrentSince Nov 1, 2018 Accepting new patients
Mainehealth Current Accepting new patients
Mainegeneral Health Past Accepting new patients

Locations

329 Bath Rd
Brunswick, ME 04011
Phone (207) 373-3012

22 Bramhall St
Portland, ME 04102
Phone (207) 662-2179

78 Atlantic Pl
South Portland, ME 04106
Phone (207) 661-6654

Organizations & group practices 5

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": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463702400000",
    "number": "1467472548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "67 EUSTIS PKWY",
            "city": "WATERVILLE",
            "state": "ME",
            "postal_code": "049015173",
            "telephone_number": "207-873-2136",
            "fax_number": "207-872-4522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "67 EUSTIS PKWY",
            "city": "WATERVILLE",
            "state": "ME",
            "postal_code": "049015173",
            "telephone_number": "207-873-2136",
            "fax_number": "207-872-4522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOENIG",
        "first_name": "CLAIRE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-20",
        "last_updated": "2016-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ME",
            "license": "LC10224",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterville, ME

Sources for this page

Verify at the official NPI Registry.