Individual provider Active NPI

Andrew James Bove, LCSW

  • Clinical Social Worker
  • Portland, ME
National Provider Identifier
1790302545
Registry record updated May 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LC18479 Issued in ME
Practice address
55 Portland St
Portland, ME 04101-2921
Phone
(207) 775-0026
NPI assigned
Jun 27, 2020
Last updated
May 19, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 19, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X LC18479 ME Primary

Addresses

Primary practice location

55 Portland St
Portland, ME 04101-2921

Mailing address

21 Ocean House Rd
Cape Elizabeth, ME 04107-1110
Phone (207) 318-5944

Other practice location 1

125 Presumpscot St
Portland, ME 04103-5225
Phone (207) 871-1000

Other practice location 2

21 Ocean House Rd
Cape Elizabeth, ME 04107-1110
Phone (207) 318-5944

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
LC18479MEMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1593216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684454400000",
    "number": "1790302545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 OCEAN HOUSE RD",
            "city": "CAPE ELIZABETH",
            "state": "ME",
            "postal_code": "041071110",
            "telephone_number": "207-318-5944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 PORTLAND ST",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041012921",
            "telephone_number": "207-775-0026"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "125 Presumpscot St",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "ME",
            "postal_code": "041035225",
            "country_code": "US",
            "telephone_number": "207-871-1000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "21 Ocean House Rd",
            "address_purpose": "LOCATION",
            "city": "Cape Elizabeth",
            "state": "ME",
            "postal_code": "041071110",
            "country_code": "US",
            "telephone_number": "207-318-5944",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOVE",
        "first_name": "ANDREW",
        "middle_name": "JAMES",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-06-27",
        "last_updated": "2023-05-19",
        "certification_date": "2023-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "ME",
            "license": "LC18479",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 May 19, 2023; 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.