Individual provider Active NPI

Julien Mario Powers-Candelmo, LCSW, CCS

  • Clinical Social Worker
  • South Portland, ME
National Provider Identifier
1982008520
Registry record updated Mar 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LC11839 Issued in ME
Practice address
650 Main St Ste 201B
South Portland, ME 04106-5448
Phone
(207) 536-4931
Fax
(207) 221-1679
NPI assigned
Oct 10, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 18, 2024

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 LC11839 ME Primary

Addresses

Primary practice location

650 Main St Ste 201B
South Portland, ME 04106-5448

Mailing address

650 Main St Ste 201B
South Portland, ME 04106-5448
Phone (207) 536-4931

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150505000034 ME Practitioner - Clinical Social Worker 4688993124 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

306 Rodman Rd
Auburn, ME 04210-3830

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Powers of the Healing Arts Therapy and Training Center, LLC Clinical CurrentSince Jul 15, 2024 Accepting new patients

Locations

650 Main St
Ste 201B
South Portland, ME 04106
Phone (207) 536-4931

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": "1412899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710720000000",
    "number": "1982008520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "650 MAIN ST STE 201B",
            "city": "SOUTH PORTLAND",
            "state": "ME",
            "postal_code": "041065448",
            "telephone_number": "207-536-4931",
            "fax_number": "207-221-1679"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 MAIN ST STE 201B",
            "city": "SOUTH PORTLAND",
            "state": "ME",
            "postal_code": "041065448",
            "telephone_number": "207-536-4931",
            "fax_number": "207-221-1679"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POWERS-CANDELMO",
        "first_name": "JULIEN",
        "middle_name": "MARIO",
        "credential": "LCSW, CCS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-10-10",
        "last_updated": "2024-03-18",
        "certification_date": "2024-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ME",
            "license": "LC11839",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Portland, ME

Sources for this page

Verify at the official NPI Registry.