Individual provider Active NPI

Hannah Rose Kazilionis, LCSW, LADC

  • Clinical Social Worker
  • Portland, ME
National Provider Identifier
1720524283
Registry record updated Nov 29, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LC17198 Issued in ME
Practice address
257 Deering Ave # 204
Portland, ME 04103
Phone
(207) 480-3491
NPI assigned
Jan 9, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X LC6367 ME
Clinical Social Worker 1041C0700X LC17198 ME Primary

Addresses

Primary practice location

257 Deering Ave # 204
Portland, ME 04103

Mailing address

257 Deering Ave # 204
Portland, ME 04103-4858
Phone (207) 480-3491

Other practice location 1

575 Forest Ave
Portland, ME 04101-1513
Phone (207) 772-1187 ext. 302

Other names 1

  • Miss Hannah Rose McComish Former name

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LC6367MEMDAddiction (Substance Use Disorder) Counselor
LC17198MEMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1483920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543449600000",
    "number": "1720524283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "257 DEERING AVE # 204",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041034858",
            "telephone_number": "207-480-3491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "257 DEERING AVE # 204",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "04103",
            "telephone_number": "207-480-3491"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "575 Forest Ave",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "ME",
            "postal_code": "041011513",
            "country_code": "US",
            "telephone_number": "207-772-1187 x302",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KAZILIONIS",
        "first_name": "HANNAH",
        "middle_name": "ROSE",
        "name_prefix": "Mrs.",
        "credential": "LCSW, LADC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-01-09",
        "last_updated": "2018-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "ME",
            "license": "LC6367",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ME",
            "license": "LC17198",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HANNAH",
            "last_name": "MCCOMISH",
            "middle_name": "ROSE",
            "prefix": "MISS",
            "credential": "LADC, LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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 Nov 29, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.