Active NPI
Jaime Mastrorio, LCSW
- Clinical Social Worker
- Portland, ME
National Provider Identifier
1679083604
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LC18378
- Practice address
- 32 Clark St
Portland, ME 04102-4100 - Phone
- (508) 243-3580
- Fax
- (207) 878-2259
- NPI assigned
- Oct 4, 2017
- 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 | LC18378 | ME | Primary |
Addresses
Primary practice location
32 Clark St
Portland, ME 04102-4100
Mailing address
32 Clark St Apt B
Portland, ME 04102-4112
Phone (508) 243-3580
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| MC16717 | Other | ME | LICENSE MAINE |
| LC18378 | Other | ME | LICENSE MAINE |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20201123000735 | ME | Practitioner - Clinical Social Worker | 5890106942 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1507075200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1656892800000",
"number": "1679083604",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "32 CLARK ST APT B",
"city": "PORTLAND",
"state": "ME",
"postal_code": "041024112",
"telephone_number": "508-243-3580"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "32 CLARK ST",
"city": "PORTLAND",
"state": "ME",
"postal_code": "041024100",
"telephone_number": "508-243-3580",
"fax_number": "207-878-2259"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MASTRORIO",
"first_name": "JAIME",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-10-04",
"last_updated": "2022-07-04",
"certification_date": "2022-07-04",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "ME",
"license": "LC18378",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE MAINE",
"identifier": "MC16717",
"state": "ME"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE MAINE",
"identifier": "LC18378",
"state": "ME"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Portland, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 4, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.