Individual provider Active NPI

Shelli Hanscom, LCSW

  • Clinical Social Worker
  • Bangor, ME
National Provider Identifier
1700294931
Registry record updated Jul 31, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LC7769 Issued in ME
Practice address
319 Union St
Bangor, ME 04401-4798
Phone
(207) 949-3228
NPI assigned
Jul 31, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 31, 2014

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 LC7769 ME Primary

Addresses

Primary practice location

319 Union St
Bangor, ME 04401-4798

Mailing address

319 Union St
Bangor, ME 04401-4798
Phone (207) 949-3228

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
I20150107002101 ME Practitioner - Clinical Social Worker 1355664863 Reassigns benefits to 1 organization
Practice locations: Bangor, ME

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
SweetserGroup PAC ID 8325946213, 138 clinicians

Practice addresses (Care Compare)

50 Moody St
Saco, ME 04072-1536

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Sweetser CurrentSince Dec 11, 2014 Accepting new patients

Locations

319 Union St
Bangor, ME 04401
Phone (207) 735-4430

28 Sweetser Dr
Belfast, ME 04915
Phone (207) 284-5981

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": "1406764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1406764800000",
    "number": "1700294931",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "319 UNION ST",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044014798",
            "telephone_number": "207-949-3228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "319 UNION ST",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044014798",
            "telephone_number": "207-949-3228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANSCOM",
        "first_name": "SHELLI",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-07-31",
        "last_updated": "2014-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ME",
            "license": "LC7769",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bangor, ME

Sources for this page

Verify at the official NPI Registry.