Roberta P. Wentworth, LCSW – Clinical Social Worker

Key facts

NPI: 1972688950
Entity type: Individual (NPI type 1)
Primary specialty: Clinical Social Worker 1041C0700X
License: LC447 (ME)
Practice address: 474 Main St
Springvale, ME 04083-1409
Phone: (207) 324-1500
Fax: (207) 490-5263
NPI assigned: Oct 26, 2006
Sex: Female
Sole proprietor: No

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.

Maine Behavioral Healthcare Mental Health Clinic/Center (Including Community Mental Health Center) · Biddeford, ME · NPI 1891733309

NPD (past)

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): Yes

State licenses

License	State	Type	Specialty
LC447	ME	MD	Clinical Social Worker

Practice roles

Organization	Specialty	Status	New patients
Maine Behavioral Healthcare		Past	Accepting new patients

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Clinical Social Worker	1041C0700X	LC447	ME	Yes

Addresses

Primary practice location

474 Main St
Springvale, ME 04083-1409

Mailing address

78 Atlantic PL
South Portland, ME 04106-2316
Phone (207) 842-7701

Other identifiers

Identifier	Type	State	Issuer
257080099	Medicaid	ME

Other providers in Springvale, ME

All providers in Springvale, ME · Clinical Social Worker in Maine

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 5, 2012. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.