Active NPI
Katina Colombotos, LCSW
- Clinical Social Worker
- Bethel, ME
National Provider Identifier
1497889299
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LC11170
- Practice address
- 19 Crescent Lane
Bethel, ME 04217 - Phone
- (207) 824-2839
- NPI assigned
- Mar 15, 2007
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | LC11170 | ME | Primary |
Addresses
Primary practice location
19 Crescent Lane
Bethel, ME 04217
Mailing address
19 Crescent St
Bethel, ME 04217-4026
Phone (207) 824-2839
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
| License | State | Type | Specialty |
|---|---|---|---|
| LC11170 | ME | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173916800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1243900800000",
"number": "1497889299",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "19 CRESCENT ST",
"city": "BETHEL",
"state": "ME",
"postal_code": "042174026",
"telephone_number": "207-824-2839"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19 CRESCENT LANE",
"city": "BETHEL",
"state": "ME",
"postal_code": "04217",
"telephone_number": "207-824-2839"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COLOMBOTOS",
"first_name": "KATINA",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-15",
"last_updated": "2009-06-02",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "ME",
"license": "LC11170",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bethel, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.