Individual provider Active NPI

Marybeth James-O'Connor, LCSW

  • Clinical Social Worker
  • Lewiston, ME
National Provider Identifier
1912054057
Registry record updated Jan 23, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LC2180 Issued in ME
Practice address
466 Main St
Suite #300
Lewiston, ME 04240-6748
Phone
(207) 782-4209
Fax
(207) 333-3291
NPI assigned
Jan 4, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 23, 2013

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 LC2180 ME Primary

Addresses

Primary practice location

466 Main St
Suite #300
Lewiston, ME 04240-6748

Mailing address

466 Main St
Suite #300
Lewiston, ME 04240-6748
Phone (207) 782-4209

Other identifiers 1

IdentifierTypeStateIssuer
211500000MedicaidME

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
I20050621000805 ME Practitioner - Clinical Social Worker 4486699428 Reassigns benefits to 1 organization
Practice locations: Lewiston, ME

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

466 Main St
Lewiston, ME 04240-6748
Phone (207) 782-4209

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Sweetser CurrentSince Oct 1, 2008 Accepting new patients

Locations

28 Sweetser Dr
Belfast, ME 04915
Phone (207) 284-5981

50 Moody St
Saco, ME 04072
Phone (207) 284-5981

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": "1167868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358899200000",
    "number": "1912054057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "466 MAIN ST",
            "address_2": "SUITE #300",
            "city": "LEWISTON",
            "state": "ME",
            "postal_code": "042406748",
            "telephone_number": "207-782-4209",
            "fax_number": "207-333-3296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "466 MAIN ST",
            "address_2": "SUITE #300",
            "city": "LEWISTON",
            "state": "ME",
            "postal_code": "042406748",
            "telephone_number": "207-782-4209",
            "fax_number": "207-333-3291"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAMES-O'CONNOR",
        "first_name": "MARYBETH",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-04",
        "last_updated": "2013-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ME",
            "license": "LC2180",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "211500000",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lewiston, ME

Sources for this page

Verify at the official NPI Registry.