Individual provider Active NPI

Vanessa Lynn Macoy, LCSW

  • Clinical Social Worker
  • Augusta, ME
National Provider Identifier
1649918426
Registry record updated Dec 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LC21766 Issued in ME
Practice address
66 Stone St
Augusta, ME 04330-5227
Phone
(207) 626-3455
NPI assigned
May 23, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2022

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 LC21766 ME Primary

Addresses

Primary practice location

66 Stone St
Augusta, ME 04330-5227

Mailing address

67 Eustis Pkwy
Waterville, ME 04901-5173
Phone (207) 660-4549

Other identifiers 1

IdentifierTypeStateIssuer
1649918426MedicaidME

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
I20230112000720 ME Practitioner - Clinical Social Worker 3375913122 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kennebec Valley Mental Health CenterGroup PAC ID 7113829383, 68 clinicians

Practice addresses (Care Compare)

67 Eustis Pkwy
Waterville, ME 04901-5173
Phone (207) 873-2136

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LC21766MEMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Kennebec Valley Mental Health Center CurrentSince Nov 28, 2022 Accepting new patients

Locations

66 Stone St
Augusta, ME 04330
Phone (207) 626-3455

10 Caldwell Rd
Augusta, ME 04330
Phone (207) 626-3448

67 Eustis Pkwy
Waterville, ME 04901
Phone (207) 660-4549

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": "1653264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670371200000",
    "number": "1649918426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "67 EUSTIS PKWY",
            "city": "WATERVILLE",
            "state": "ME",
            "postal_code": "049015173",
            "telephone_number": "207-660-4549",
            "fax_number": "207-660-4529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "66 STONE ST",
            "city": "AUGUSTA",
            "state": "ME",
            "postal_code": "043305227",
            "telephone_number": "207-626-3455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACOY",
        "first_name": "VANESSA",
        "middle_name": "LYNN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-23",
        "last_updated": "2022-12-07",
        "certification_date": "2022-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ME",
            "license": "LC21766",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1649918426",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Augusta, ME

Sources for this page

Verify at the official NPI Registry.