Mary Carol Kennedy I, MSW, LCSW, CCS, LADC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LC4943 Issued in ME

Practice address

23 Water St
Suite 7
Saco, ME 04072-5119

Phone

(207) 284-1173

NPI assigned

Jan 14, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Sweetser

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Saco, ME
  • NPI 1538122445
  Medicare reassignment NPD

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

{
    "created_epoch": "1200268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211414400000",
    "number": "1720264336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 SCAMMON ST",
            "address_2": "SUITE 19-181",
            "city": "SACO",
            "state": "ME",
            "postal_code": "040725121",
            "telephone_number": "207-284-1173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23 WATER ST",
            "address_2": "SUITE 7",
            "city": "SACO",
            "state": "ME",
            "postal_code": "040725119",
            "telephone_number": "207-284-1173"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "MARY",
        "middle_name": "CAROL",
        "name_suffix": "I",
        "credential": "MSW, LCSW, CCS, LADC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-01-14",
        "last_updated": "2008-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "ME",
            "license": "LC3972",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ME",
            "license": "LC4943",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "200938",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kayla B Ouellette, LCSW LLC
• Meghan Lea Keane, MD
• David C Kelley, LMSW-CC
• James E Kelley, DDS
• Megan Lyn Kemna, LMSW-CC
• Hylton Chris Kerr, LCSW
• Karen L. Kesselring, LCSW
• Donna C Kim, MD
• David C Kinsella, LMSW-CC
• Elizabeth A Kinsella, CADC

• Clinical Social Worker in Saco, ME
• Providers in Saco, ME by specialty
• Clinical Social Worker in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2008; 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.

Verify at the official NPI Registry.