Amber R Elliott, LCSW

Key facts

NPI

1780949800

Entity type

Individual (NPI type 1)

Primary specialty

Clinical Social Worker 1041C0700X

License

LC12988 (ME)

Practice address

227 Congress St
3Rd Floor
Portland, ME 04101-3609

Phone

(207) 590-9207

Fax

(207) 282-5230

NPI assigned

Jul 5, 2012

Sex

Female

Sole proprietor

Yes

Organizations & group practices 2

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.

• Alternative Wellness Services Community/Behavioral Health Agency · Biddeford, ME · NPI 1982046207
  Medicare reassignment Care Compare group NPD Authorized official ME
• Primecare Physician Associates Family Medicine Physician · Biddeford, ME · NPI 1831150911
  NPD (past)

Medicare Care Compare profile

Specialty

Clinical Social Worker

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Alternative Wellness Services (6 clinicians)

Practice addresses (Care Compare)

Medicare participation

Medicare fee-for-service enrollment

Enrolled in ME

Eligible to order & refer

Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No

Medicare enrollment records

National Provider Directory

Medicare enrollment (NPD)

Yes

State licenses

Practice roles

Locations

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jul 5, 2012.

{
    "created_epoch": "1341446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1341446400000",
    "number": "1780949800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1565",
            "city": "BIDDEFORD",
            "state": "ME",
            "postal_code": "040051565",
            "telephone_number": "207-590-9207",
            "fax_number": "207-282-5230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "227 CONGRESS ST",
            "address_2": "3RD FLOOR",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041013609",
            "telephone_number": "207-590-9207",
            "fax_number": "207-282-5230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIOTT",
        "first_name": "AMBER",
        "middle_name": "R",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-07-05",
        "last_updated": "2012-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ME",
            "license": "LC12988",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, ME

• Jenna Elkhoury, MD
• Kristen M Ellensohn, APRN FNP
• Jaime Eller, LCSW
• Sara A Ellingwood, M.S.
• Emily E Elliot, LCPC-C
• Autumn Elliott
• Catherine M Elliott, CRNA
• Quinn Elliott
• Kent A Ellis
• Lauren Brooke Ellis, MD

All providers in Portland, ME · Clinical Social Worker in Maine