Individual provider Active NPI

Elanda Isabella Mariquita Atencio, LMSW-CC

  • Clinical Social Worker
  • Portland, ME
National Provider Identifier
1497564264
Registry record updated Jan 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
MC23420 Issued in ME
Practice address
501 Forest Ave
Portland, ME 04101-1503
Phone
(207) 536-1591
NPI assigned
Jan 6, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2025

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 MC23420 ME Primary

Addresses

Primary practice location

501 Forest Ave
Portland, ME 04101-1503

Mailing address

162 Mount Hunger Shore Rd
Windham, ME 04062-5636
Phone (207) 894-0497

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
MC23420MEMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1736121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736121600000",
    "number": "1497564264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "162 MOUNT HUNGER SHORE RD",
            "city": "WINDHAM",
            "state": "ME",
            "postal_code": "040625636",
            "telephone_number": "207-894-0497"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 FOREST AVE",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041011503",
            "telephone_number": "207-536-1591"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ATENCIO",
        "first_name": "ELANDA ISABELLA",
        "middle_name": "MARIQUITA",
        "credential": "LMSW-CC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-01-06",
        "last_updated": "2025-01-06",
        "certification_date": "2025-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ME",
            "license": "MC23420",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.