Individual provider Active NPI

Beth Kittredge, LCSW

  • Clinical Social Worker
  • Yarmouth, ME
National Provider Identifier
1891337358
Registry record updated Oct 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LC18266 Issued in ME
Practice address
26 School Street 3Rd Floor
Yarmouth, ME 04096-0409
Phone
(207) 409-3730
NPI assigned
Oct 16, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 16, 2019

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 LC18266 ME Primary

Addresses

Primary practice location

26 School Street 3Rd Floor
Yarmouth, ME 04096-0409

Mailing address

26 School St Floor 3
Yarmouth, ME 04096-4710
Phone (207) 409-3730

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LC18266MEMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1571184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571184000000",
    "number": "1891337358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26 SCHOOL ST FLOOR 3",
            "city": "YARMOUTH",
            "state": "ME",
            "postal_code": "040964710",
            "telephone_number": "207-409-3730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26 SCHOOL STREET 3RD FLOOR",
            "city": "YARMOUTH",
            "state": "ME",
            "postal_code": "040960409",
            "telephone_number": "207-409-3730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KITTREDGE",
        "first_name": "BETH",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-10-16",
        "last_updated": "2019-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ME",
            "license": "LC18266",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yarmouth, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2019; 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.