Active NPI
Shannon Lea Taylor, LCSW
- Clinical Social Worker
- Biddeford, ME
National Provider Identifier
1558619742
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- MC13363
- Practice address
- 40 Main St BLDG 13
Biddeford, ME 04005-5178 - Phone
- (207) 871-1200
- Fax
- (207) 871-1232
- NPI assigned
- Aug 21, 2012
- 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 | MC13363 | ME | Primary |
Addresses
Primary practice location
40 Main St BLDG 13
Biddeford, ME 04005-5178
Mailing address
901 Washington Ave Ste 100
Portland, ME 04103-2842
Phone (207) 871-1211
Other practice location 1
15 York St
building 19
Biddeford, ME 04005-5507
Phone (207) 283-0587
Other names 1
- Shannon Lea Tucker
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MC13363 | ME | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Spurwink Services Incorporated | 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.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Portland, ME
- NPI 1316945090
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1345507200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1539129600000",
"number": "1558619742",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "901 WASHINGTON AVE STE 100",
"city": "PORTLAND",
"state": "ME",
"postal_code": "041032842",
"telephone_number": "207-871-1211",
"fax_number": "207-871-1232"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "40 MAIN ST BLDG 13",
"city": "BIDDEFORD",
"state": "ME",
"postal_code": "040055178",
"telephone_number": "207-871-1200",
"fax_number": "207-871-1232"
}
],
"practiceLocations": [
{
"address_1": "15 York St",
"address_2": "building 19",
"address_purpose": "LOCATION",
"city": "Biddeford",
"state": "ME",
"postal_code": "040055507",
"country_code": "US",
"telephone_number": "207-283-0587",
"fax_number": "207-283-2850",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "TAYLOR",
"first_name": "SHANNON",
"middle_name": "LEA",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-08-21",
"last_updated": "2018-10-10",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "ME",
"license": "MC13363",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "SHANNON",
"last_name": "TUCKER",
"middle_name": "LEA",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Biddeford, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.