Individual provider Active NPI

Susan S Stickney, LCSW

  • Clinical Social Worker
  • Saco, ME
National Provider Identifier
1619987435
Registry record updated Oct 12, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LC13027 Issued in ME
Practice address
333 Lincoln St
Saco, ME 04072-3113
Phone
(207) 333-0476
NPI assigned
Aug 8, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2011

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 LC13027 ME Primary

Addresses

Primary practice location

333 Lincoln St
Saco, ME 04072-3113

Mailing address

1397 Royalsborough Rd
Durham, ME 04222-5231

Other identifiers 1

IdentifierTypeStateIssuer
244250099MedicaidME

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME
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 1

Enrollment IDStateProvider typePAC IDDetails
I20111201000172 ME Practitioner - Clinical Social Worker 4183898133 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
SweetserGroup PAC ID 8325946213, 138 clinicians

Practice addresses (Care Compare)

329 Bath Rd
Brunswick, ME 04011-2673
Phone (207) 373-3177

50 Moody St
Saco, ME 04072-1536
Phone (800) 434-3000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LC13027MEMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Sweetser CurrentSince Sep 13, 2011 Accepting new patients

Locations

329 Bath Rd
Brunswick, ME 04011
Phone (207) 373-3012

50 Moody St
Saco, ME 04072
Phone (207) 284-5981

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.

NPI Registry JSON

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

{
    "created_epoch": "1154995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318377600000",
    "number": "1619987435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1397 ROYALSBOROUGH RD",
            "city": "DURHAM",
            "state": "ME",
            "postal_code": "042225231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 LINCOLN ST",
            "city": "SACO",
            "state": "ME",
            "postal_code": "040723113",
            "telephone_number": "207-333-0476"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STICKNEY",
        "first_name": "SUSAN",
        "middle_name": "S",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-08",
        "last_updated": "2011-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ME",
            "license": "LC13027",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "244250099",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saco, ME

Sources for this page

Verify at the official NPI Registry.