Individual provider Active NPI

Elisabeth R Corrales, LCSW

  • Clinical Social Worker
  • Portland, ME
National Provider Identifier
1861003261
Registry record updated Apr 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LC21464 Issued in ME
Practice address
901 Washington Ave Ste 100
Portland, ME 04103-2842
Phone
(207) 871-1200
Fax
(207) 871-1232
NPI assigned
Aug 11, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X MC18607 ME
Clinical Social Worker 1041C0700X LC21464 ME Primary

Addresses

Primary practice location

901 Washington Ave Ste 100
Portland, ME 04103-2842

Mailing address

PO Box 1599
Bangor, ME 04402-1599
Phone (207) 404-8100

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20230522000241 ME Practitioner - Clinical Social Worker 1658737432 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Penobscot Community Health CenterGroup PAC ID 0143212670, 135 clinicians
Spurwink Services IncorporatedGroup PAC ID 7810026945, 87 clinicians

Practice addresses (Care Compare)

29 Schoodic Dr
Belfast, ME 04915-7246
Phone (207) 338-6900

901 Washington Ave
Suite 100
Portland, ME 04103-2842
Phone (207) 871-1200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MC18607MEMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Penobscot Community Health Center Current Accepting new patients
Spurwink Services Incorporated CurrentSince Jan 28, 2026 Accepting new patients
Synapse and Soul Therapy LLC Clinical Current Accepting new patients
Penobscot Community Health Center CurrentSince May 1, 2023 Accepting new patients
Penobscot Community Health Center CurrentSince May 1, 2023 Accepting new patients

Locations

1012 Union St
Ste 1
Bangor, ME 04401
Phone 2079455247407

29 Schoodic Dr
Belfast, ME 04915
Phone (207) 218-6001

53 Schoodic Dr
Belfast, ME 04915
Phone (207) 338-6900

901 Washington Ave
Ste 100
Portland, ME 04103
Phone 20787112112145

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1597104000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776211200000",
    "number": "1861003261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1599",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044021599",
            "telephone_number": "207-404-8100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 WASHINGTON AVE STE 100",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041032842",
            "telephone_number": "207-871-1200",
            "fax_number": "207-871-1232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORRALES",
        "first_name": "ELISABETH",
        "middle_name": "R",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-11",
        "last_updated": "2026-04-15",
        "certification_date": "2026-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ME",
            "license": "MC18607",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ME",
            "license": "LC21464",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, ME

Sources for this page

Verify at the official NPI Registry.