Individual provider Active NPI

Elizabeth M Dostie, LCSW

  • Clinical Social Worker
  • Waterville, ME
National Provider Identifier
1568400067
Registry record updated Mar 11, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSWLC7176 Issued in ME
Practice address
93 Silver St
Waterville, ME 04901-5923
Phone
(207) 873-2330
Fax
(207) 873-3795
NPI assigned
Jun 4, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2015

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 LCSWLC7176 ME Primary

Addresses

Primary practice location

93 Silver St
Waterville, ME 04901-5923

Mailing address

93 Silver St
Waterville, ME 04901-5923
Phone (207) 873-2330

Other identifiers 1

IdentifierTypeStateIssuer
432092199MedicaidME

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

LicenseStateTypeSpecialty
LCSWLC7176MEMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1149379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1426032000000",
    "number": "1568400067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "93 SILVER ST",
            "city": "WATERVILLE",
            "state": "ME",
            "postal_code": "049015923",
            "telephone_number": "207-873-2330",
            "fax_number": "207-873-3795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "93 SILVER ST",
            "city": "WATERVILLE",
            "state": "ME",
            "postal_code": "049015923",
            "telephone_number": "207-873-2330",
            "fax_number": "207-873-3795"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOSTIE",
        "first_name": "ELIZABETH",
        "middle_name": "M",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-04",
        "last_updated": "2015-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ME",
            "license": "LCSWLC7176",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "432092199",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterville, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2015; 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.