Miranda Jeanne Fearon, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LC14954 Issued in ME

Practice address

268 Stillwater Ave
Bangor, ME 04401-3945

Phone

(207) 973-6100

NPI assigned

Dec 27, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Clinical Social Worker

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Health Affiliates Maine, LLCGroup PAC ID 1951594076, 169 clinicians

Practice addresses (Care Compare)

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.

• Health Affiliates Maine, LLC

  • Community/Behavioral Health Agency
  • Auburn, ME
  • NPI 1932413556
  Medicare reassignment Care Compare group NPD
• Acadia Hospital Corp

  • Psychiatric Hospital
  • Bangor, ME
  • NPI 1215940523
  Medicare reassignment NPD
• McKay Counseling PLLC

  • Professional Counselor
  • Brewer, ME
  • NPI 1568058311
  NPD
• Acadia Healthcare, Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Bangor, ME
  • NPI 1568477297
  NPD (past)

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

{
    "created_epoch": "1356566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409184000000",
    "number": "1831435502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "268 STILLWATER AVE",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044013945",
            "telephone_number": "207-973-6100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "268 STILLWATER AVE",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044013945",
            "telephone_number": "207-973-6100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FEARON",
        "first_name": "MIRANDA",
        "middle_name": "JEANNE",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-12-27",
        "last_updated": "2014-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ME",
            "license": "LC14954",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gregg M Farrell, M.D.
• Amina Faruque, MD
• Rebecca Faulkner
• Ameena Fauq, PA-C
• Jordan Ciel Fearon, PSYD
• Sandra L Feher, OTR/L
• Amy Teresa Fenwick, MD
• Enrique A Feoli, M.D.
• Lori J Ferguson, LCSW
• Gary Warren Fessler, DDS

• Clinical Social Worker in Bangor, ME
• Providers in Bangor, 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 Aug 28, 2014; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.