Active NPI
Misty Renee Richardson, LCSW
- Clinical Social Worker
- Bangor, ME
National Provider Identifier
1689004269
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LC14516
- Practice address
- 268 Stillwater Ave
Bangor, ME 04401-3945 - Phone
- (207) 973-9548
- Fax
- (207) 973-6437
- NPI assigned
- Nov 19, 2013
- Sex
- Female
- Sole proprietor
- No
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 | LC14516 | ME | Primary |
Addresses
Primary practice location
268 Stillwater Ave
Bangor, ME 04401-3945
Mailing address
268 Stillwater Ave
PO Box 422
Bangor, ME 04401-3945
Phone (207) 973-9548
Other names 1
- Misty Renee Files
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
| License | State | Type | Specialty |
|---|---|---|---|
| LC14516 | ME | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1384819200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1384819200000",
"number": "1689004269",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "268 STILLWATER AVE",
"address_2": "PO BOX 422",
"city": "BANGOR",
"state": "ME",
"postal_code": "044013945",
"telephone_number": "207-973-9548",
"fax_number": "207-973-6437"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "268 STILLWATER AVE",
"city": "BANGOR",
"state": "ME",
"postal_code": "044013945",
"telephone_number": "207-973-9548",
"fax_number": "207-973-6437"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RICHARDSON",
"first_name": "MISTY",
"middle_name": "RENEE",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-11-19",
"last_updated": "2013-11-19",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "ME",
"license": "LC14516",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "MISTY",
"last_name": "FILES",
"middle_name": "RENEE",
"credential": "LCSW",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Bangor, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.