Elizabeth R Small, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LC11594 Issued in ME

Practice address

157 Park St
Suite 35
Bangor, ME 04401-5093

Phone

(207) 992-9454

NPI assigned

Sep 24, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Health Psych Maine, LLC

  • Health Service Psychologist
  • Waterville, ME
  • NPI 1134146798
  NPD

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

{
    "created_epoch": "1222214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1309132800000",
    "number": "1891945176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "157 PARK ST",
            "address_2": "SUITE 35",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044015093",
            "telephone_number": "207-992-9454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "157 PARK ST",
            "address_2": "SUITE 35",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044015093",
            "telephone_number": "207-992-9454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMALL",
        "first_name": "ELIZABETH",
        "middle_name": "R",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-09-24",
        "last_updated": "2011-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ME",
            "license": "LC11594",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shelby J Slauenwhite, PAC
• Sleep Well Inc
• Alexandrea Sleeper
• Michelle Elizabeth Varney Slike, PT, DPT
• Edward Victor Small Jr., PTA
• Jessica Demerise Small, LCPC
• Patricia Small, DO
• Smart Vision, LLC
• Mandi Lynn Smiley, CADC
• Eileen L Smith Porter, R.D.

• All providers in Bangor, ME
• Clinical Social Worker in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2011; 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.