Individual provider Active NPI

Rachel Elizabeth Bennett, LCSW

  • Clinical Social Worker
  • Boothbay Harbor, ME
National Provider Identifier
1891705174
Registry record updated Sep 27, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LC10996 Issued in ME
Practice address
137 Townsend Ave
Boothbay Harbor, ME 04538-1845
Phone
(207) 624-1342
NPI assigned
Aug 9, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 27, 2016

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 LC10996 ME Primary

Addresses

Primary practice location

137 Townsend Ave
Boothbay Harbor, ME 04538-1845

Mailing address

PO Box 95
Boothbay Harbor, ME 04538-0095
Phone (207) 624-1342

Other identifiers 1

IdentifierTypeStateIssuer
431729599MedicaidME

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
I20161012000444 ME Practitioner - Clinical Social Worker 5799867727 Practice locations: Damariscotta, ME

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LC10996MEMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Sweetser Past Accepting new patients

Organizations & group practices 1

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": "1155081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1474934400000",
    "number": "1891705174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 95",
            "city": "BOOTHBAY HARBOR",
            "state": "ME",
            "postal_code": "045380095",
            "telephone_number": "207-624-1342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "137 TOWNSEND AVE",
            "city": "BOOTHBAY HARBOR",
            "state": "ME",
            "postal_code": "045381845",
            "telephone_number": "207-624-1342"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENNETT",
        "first_name": "RACHEL",
        "middle_name": "ELIZABETH",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-09",
        "last_updated": "2016-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ME",
            "license": "LC10996",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "431729599",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boothbay Harbor, ME

Sources for this page

Verify at the official NPI Registry.