Rose a Bradshaw, LCSW, PA

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

ROSE A BRADSHAW, LCSW, PA

Practice address

40 Forest Falls Dr Ste 3
Yarmouth, ME 04096-6905

Phone

(207) 671-0305

Fax

(207) 669-4837

NPI assigned

Oct 30, 2018

Last updated

Oct 30, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Rose A Bradshaw, LCSWNPI 1437239910

Title

President

Phone

(207) 671-0305

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Rose Anne Bradshaw, LCSW

  • Clinical Social Worker
  • Portland, ME
  • NPI 1437239910
  Authorized official Same address or phone

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

{
    "created_epoch": "1540857600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1540857600000",
    "number": "1841767795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "137 MIDDLE RD",
            "city": "CUMBERLAND",
            "state": "ME",
            "postal_code": "040213710",
            "telephone_number": "207-671-0305",
            "fax_number": "207-669-4837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 FOREST FALLS DR STE 3",
            "city": "YARMOUTH",
            "state": "ME",
            "postal_code": "040966905",
            "telephone_number": "207-671-0305",
            "fax_number": "207-669-4837"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROSE A BRADSHAW, LCSW, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-30",
        "last_updated": "2018-10-30",
        "status": "A",
        "authorized_official_last_name": "BRADSHAW",
        "authorized_official_first_name": "ROSE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "207-671-0305",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1437239910",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Christopher Ross, LCPC, LADC, CCS
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• Clinical Social Worker in Yarmouth, ME
• Providers in Yarmouth, 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 Oct 30, 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.