Individual provider Active NPI

Elizabeth Cleverly, LCSW

  • Clinical Social Worker
  • Rockland, ME
National Provider Identifier
1912130485
Registry record updated Dec 16, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LC12989 Issued in ME
Practice address
12 Union St
Rockland, ME 04841-2739
Phone
(207) 701-4477
Fax
(207) 701-4486
NPI assigned
Aug 31, 2009
Last updated
Dec 16, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2011

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 LC12989 ME Primary

Addresses

Primary practice location

12 Union St
Rockland, ME 04841-2739

Mailing address

78 Atlantic PL
South Portland, ME 04106-2316
Phone (207) 842-6540

Other identifiers 1

IdentifierTypeStateIssuer
45339499MedicaidME

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
I20111011000031 ME Practitioner - Clinical Social Worker 8325210628 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Sweetser CurrentSince Jan 1, 2015 Accepting new patients

Locations

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

329 Bath Rd
Brunswick, ME 04011
Phone (207) 373-3012

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1251676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323993600000",
    "number": "1912130485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "78 ATLANTIC PL",
            "city": "SOUTH PORTLAND",
            "state": "ME",
            "postal_code": "041062316",
            "telephone_number": "207-842-6540",
            "fax_number": "207-842-7773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 UNION ST",
            "city": "ROCKLAND",
            "state": "ME",
            "postal_code": "048412739",
            "telephone_number": "207-701-4477",
            "fax_number": "207-701-4486"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLEVERLY",
        "first_name": "ELIZABETH",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-08-31",
        "last_updated": "2011-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ME",
            "license": "LC12989",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "45339499",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockland, ME

Sources for this page

Verify at the official NPI Registry.