Individual provider Active NPI

Mia Loren Yaron, LCSW

  • Clinical Social Worker
  • Westbrook, ME
National Provider Identifier
1710050885
Registry record updated Dec 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LC12348 Issued in ME
Practice address
123 Andover Rd
Westbrook, ME 04092-3848
Phone
(207) 661-6071
Fax
(207) 661-6056
NPI assigned
Nov 16, 2006
Last updated
Dec 16, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 16, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 13996 CA
Clinical Social Worker 1041C0700X LC12348 ME Primary

Addresses

Primary practice location

123 Andover Rd
Westbrook, ME 04092-3848

Mailing address

123 Andover Rd
Westbrook, ME 04092-3848
Phone (207) 662-6071

Other identifiers 1

IdentifierTypeStateIssuer
3540OtherCACOUNTY ID

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
13996CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mainehealth Current Accepting new patients

Locations

22 Bramhall St
Portland, ME 04102
Phone (207) 662-2179

123 Andover Rd
Westbrook, ME 04092
Phone (207) 761-2200

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1163635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576454400000",
    "number": "1710050885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "123 ANDOVER RD",
            "city": "WESTBROOK",
            "state": "ME",
            "postal_code": "040923848",
            "telephone_number": "207-662-6071",
            "fax_number": "408-876-4230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 ANDOVER RD",
            "city": "WESTBROOK",
            "state": "ME",
            "postal_code": "040923848",
            "telephone_number": "207-661-6071",
            "fax_number": "207-661-6056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YARON",
        "first_name": "MIA",
        "middle_name": "LOREN",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-16",
        "last_updated": "2019-12-16",
        "certification_date": "2019-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "13996",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ME",
            "license": "LC12348",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COUNTY ID",
            "identifier": "3540",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Westbrook, ME

Sources for this page

Verify at the official NPI Registry.