Emilie N Raistrick, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LC21114 Issued in ME

Practice address

30 Houlton St
Patten, ME 04765-3035

Phone

(866) 366-5842

NPI assigned

Nov 14, 2020

Last updated

Mar 28, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

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

• Katahdin Valley Health Center

  • Federally Qualified Health Center (FQHC)
  • Houlton, ME
  • NPI 1376618546
  NPD
• Nurture From Within Counseling LLC

  • Clinical Social Worker
  • Palm Coast, FL
  • NPI 1811742216
  NPD

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

{
    "created_epoch": "1605312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648425600000",
    "number": "1942802806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 LEANNI WAY UNIT C4",
            "city": "PALM COAST",
            "state": "FL",
            "postal_code": "321374755",
            "telephone_number": "386-627-8156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 HOULTON ST",
            "city": "PATTEN",
            "state": "ME",
            "postal_code": "047653035",
            "telephone_number": "866-366-5842"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAISTRICK",
        "first_name": "EMILIE",
        "middle_name": "N",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-14",
        "last_updated": "2022-03-28",
        "certification_date": "2022-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW17749",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ME",
            "license": "LC21114",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Susan Plissey, APRN-CNP
• Karen Possessky, LCSW
• Danica L Pray, MA
• Cynthia Qualey, RDH
• Lacey E Qualey, R.N.
• Bradley Joseph Rhatigan, ARNP
• Randall S Roberts
• Kimberly Iverne Rodriguez, CRMA
• Rose M Fuchs (Cornerstone Family Practice)
• Windy M Scott, CNA

• Clinical Social Worker in Patten, ME
• Providers in Patten, 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 Mar 28, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.