Individual provider Active NPI

Juleen Ann Chiaradonna, MSW, LICSW

  • Clinical Social Worker
  • York, ME
National Provider Identifier
1619267010
Registry record updated Jul 16, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LC13360 Issued in ME
Practice address
4 Market Place Dr
Suite 202a
York, ME 03909-1698
Phone
(603) 387-4388
Fax
(603) 522-8768
NPI assigned
Apr 19, 2011
Last updated
Jul 16, 2013By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 16, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LC13360 ME Primary
Clinical Social Worker 1041C0700X 1440 NH

Addresses

Primary practice location

4 Market Place Dr
Suite 202a
York, ME 03909-1698

Mailing address

4 Market Place Dr
Suite 202a
York, ME 03909-1698
Phone (603) 387-4388

Other identifiers 2

IdentifierTypeStateIssuer
1619267010MedicaidME
003014301OtherMEDICARE PTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME, NH2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20121213000426 ME Practitioner - Clinical Social Worker 0345492666 Practice locations: Sanford, ME
I20221019000537 NH Practitioner - Clinical Social Worker 0345492666 Practice locations: Rochester, NH

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

25 Daigle LN
Sanford, ME 04073-3952
Phone (603) 387-4388

39 Topaz LN
Rochester, NH 03839-5703
Phone (603) 387-4388

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2462NHMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1303171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1373932800000",
    "number": "1619267010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 MARKET PLACE DR",
            "address_2": "SUITE 202A",
            "city": "YORK",
            "state": "ME",
            "postal_code": "039091698",
            "telephone_number": "603-387-4388",
            "fax_number": "603-522-8768"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 MARKET PLACE DR",
            "address_2": "SUITE 202A",
            "city": "YORK",
            "state": "ME",
            "postal_code": "039091698",
            "telephone_number": "603-387-4388",
            "fax_number": "603-522-8768"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHIARADONNA",
        "first_name": "JULEEN",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "MSW, LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-04-19",
        "last_updated": "2013-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ME",
            "license": "LC13360",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NH",
            "license": "1440",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1619267010",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "003014301",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in York, ME

Sources for this page

Verify at the official NPI Registry.