Individual provider Active NPI

Victoria P. Kendrick, LCSW

  • Clinical Social Worker
  • Yarmouth, ME
National Provider Identifier
1871509414
Registry record updated Jun 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LC5469 Issued in ME
Practice address
261 Main St
Yarmouth, ME 04096-6755
Phone
(207) 846-1181
Fax
(207) 847-3529
NPI assigned
Aug 1, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 27, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LC5469 ME Primary

Addresses

Primary practice location

261 Main St
Yarmouth, ME 04096-6755

Mailing address

261 Main St
Yarmouth, ME 04096-6755
Phone (207) 846-1181

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
I20120829000091 ME Practitioner - Clinical Social Worker 2860649779 Practice locations: Yarmouth, ME

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

261 Main St
Yarmouth, ME 04096-6755
Phone (207) 846-1181

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LC5469MEMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340755200000",
    "number": "1871509414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "261 MAIN ST",
            "city": "YARMOUTH",
            "state": "ME",
            "postal_code": "040966755",
            "telephone_number": "207-846-1181",
            "fax_number": "207-847-3529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "261 MAIN ST",
            "city": "YARMOUTH",
            "state": "ME",
            "postal_code": "040966755",
            "telephone_number": "207-846-1181",
            "fax_number": "207-847-3529"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENDRICK",
        "first_name": "VICTORIA",
        "middle_name": "P.",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-01",
        "last_updated": "2012-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ME",
            "license": "LC5469",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yarmouth, ME

Sources for this page

Verify at the official NPI Registry.