Individual provider Active NPI

Diantha Sarah Bovey, LCSW

  • Clinical Social Worker
  • Belfast, ME
National Provider Identifier
1861935405
Registry record updated Jan 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LC15824 Issued in ME
Practice address
36 Swan Lake Ave
Belfast, ME 04915-7016
Phone
(207) 322-2170
NPI assigned
Nov 30, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 24, 2020

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 .13224 SC
Clinical Social Worker 1041C0700X LC15824 ME Primary

Addresses

Primary practice location

36 Swan Lake Ave
Belfast, ME 04915-7016

Mailing address

36 Swan Lake Ave
Belfast, ME 04915-7016
Phone (207) 322-2170

Other practice location 1

220 Ronnie Ct Ste 2
Myrtle Beach, SC 29579-4192
Phone (843) 902-9274

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME, SC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20170106000572 ME Practitioner - Clinical Social Worker 7810278827 Reassigns benefits to 1 organization
I20200504002084 SC Practitioner - Clinical Social Worker 7810278827 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kennebec Valley Mental Health CenterGroup PAC ID 7113829383, 68 clinicians

Practice addresses (Care Compare)

67 Eustis Pkwy
Waterville, ME 04901-5173
Phone (207) 873-2136

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LC15824MEMDClinical Social Worker
.13224SCMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Coastal Haven Counseling LLC CurrentSince Mar 10, 2020 Accepting new patients

Locations

3100 Dick Pond Rd
Ste D2
Myrtle Beach, SC 29588
Phone (843) 945-0346

220 Ronnie Ct
Ste 2
Myrtle Beach, SC 29579
Phone (843) 732-6830

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1480464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579824000000",
    "number": "1861935405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36 SWAN LAKE AVE",
            "city": "BELFAST",
            "state": "ME",
            "postal_code": "049157016",
            "telephone_number": "207-322-2170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36 SWAN LAKE AVE",
            "city": "BELFAST",
            "state": "ME",
            "postal_code": "049157016",
            "telephone_number": "207-322-2170"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "220 Ronnie Ct Ste 2",
            "address_purpose": "LOCATION",
            "city": "Myrtle Beach",
            "state": "SC",
            "postal_code": "295794192",
            "country_code": "US",
            "telephone_number": "843-902-9274",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOVEY",
        "first_name": "DIANTHA",
        "middle_name": "SARAH",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-11-30",
        "last_updated": "2020-01-24",
        "certification_date": "2020-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "SC",
            "license": ".13224",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ME",
            "license": "LC15824",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Belfast, ME

Sources for this page

Verify at the official NPI Registry.