Ida M. O'Donnell, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LC4676 Issued in ME

Practice address

813 Broadway
Art of Awareness, Inc.
South Portland, ME 04106-2708

Phone

(207) 799-1331

Fax

(207) 799-1350

NPI assigned

Jul 28, 2006

Sex

Female

Sole proprietor

No

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

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

{
    "created_epoch": "1154044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1337126400000",
    "number": "1902810468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "813 BROADWAY",
            "address_2": "ART OF AWARENESS, INC.",
            "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",
            "address_2": "ART OF AWARENESS, INC.",
            "city": "SOUTH PORTLAND",
            "state": "ME",
            "postal_code": "041062708",
            "telephone_number": "207-799-1331",
            "fax_number": "207-799-1350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'DONNELL",
        "first_name": "IDA",
        "middle_name": "M.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-28",
        "last_updated": "2012-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ME",
            "license": "LC4676",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katherine Noyes
• NR Maine LLC
• Shannon O'Brien, BCBA
• Tara O'Brien, ND
• Cailin E O'Connor, LMT
• Meghann O'Donnell
• Patrice M O'Hara, LMT
• Kathryn Elizabeth O'Heir, MSLP
• Megan O'Neill, LCPC
• Anna O'Sullivan, LCPC-C

• Clinical Social Worker in South Portland, ME
• Providers in South Portland, ME by specialty
• Clinical Social Worker in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2012; 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.