NPIMap

Organization Active NPI

Art of Awareness, Inc.

  • Clinical Social Worker
  • South Portland, ME
National Provider Identifier
1891833760
Registry record updated May 17, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LC4676 Issued in ME
Legal business name
ART OF AWARENESS, INC.
Practice address
813 Broadway
South Portland, ME 04106-2708
Phone
(207) 799-1331
Fax
(207) 799-1350
NPI assigned
Feb 2, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 17, 2012

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

Authorized official

Name
Ida M. O'Donnell, L.C.S.W.
Title
Director
Phone
(207) 799-1331

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X LC4676 ME Primary

Addresses

Primary practice location

813 Broadway
South Portland, ME 04106-2708

Mailing address

813 Broadway
South Portland, ME 04106-2708
Phone (207) 799-1331

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130620000157 ME Part B Supplier - Clinic/Group Practice 6204075435 Receives reassigned benefits from 10 practitioners
Practice locations: South Portland, ME

National Provider Directory

National Provider Directory

Locations

100 Waterman Dr
Ste 201
South Portland, ME 04106
Phone (207) 613-4125

813 Broadway
South Portland, ME 04106
Phone (207) 650-6450

Practitioners & affiliated clinicians

Practitioners 15

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1170374400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1337212800000",
    "number": "1891833760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "813 BROADWAY",
            "city": "SOUTH PORTLAND",
            "state": "ME",
            "postal_code": "041062708",
            "telephone_number": "207-799-1331",
            "fax_number": "207-799-1350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "813 BROADWAY",
            "city": "SOUTH PORTLAND",
            "state": "ME",
            "postal_code": "041062708",
            "telephone_number": "207-799-1331",
            "fax_number": "207-799-1350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ART OF AWARENESS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-02",
        "last_updated": "2012-05-17",
        "status": "A",
        "authorized_official_last_name": "O'DONNELL",
        "authorized_official_first_name": "IDA",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "207-799-1331",
        "authorized_official_credential": "L.C.S.W."
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "ME",
            "license": "LC4676",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Portland, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.