Active NPI
Starla Kaye Geannikis, LCSW
- Clinical Social Worker
- Brunswick, ME
National Provider Identifier
1982665964
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LC7505
- Practice address
- 10 Cumberland St
Brunswick, ME 04011-1932 - Phone
- (207) 319-3079
- Fax
- (207) 607-4015
- NPI assigned
- Mar 30, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | LC7505 | ME | Primary |
Addresses
Primary practice location
10 Cumberland St
Brunswick, ME 04011-1932
Mailing address
10 Cumberland St
Brunswick, ME 04011-1932
Phone (207) 319-3079
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20111222000222 | ME | Practitioner - Clinical Social Worker | 3072789015 | Practice locations: Brunswick, ME |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 1990
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
8 Gilman Ave
Apt 1
Brunswick, ME 04011-1938
Phone (207) 319-3079
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LC7505 | ME | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1143676800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1320710400000",
"number": "1982665964",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10 CUMBERLAND ST",
"city": "BRUNSWICK",
"state": "ME",
"postal_code": "040111932",
"telephone_number": "207-319-3079",
"fax_number": "207-607-4015"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10 CUMBERLAND ST",
"city": "BRUNSWICK",
"state": "ME",
"postal_code": "040111932",
"telephone_number": "207-319-3079",
"fax_number": "207-607-4015"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GEANNIKIS",
"first_name": "STARLA",
"middle_name": "KAYE",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-03-30",
"last_updated": "2011-11-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "ME",
"license": "LC7505",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brunswick, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2011; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.