SHANE SULLIVAN SIMPSON (LCSW) – Clinical Social Worker, NPI 1053471995

SHANE SULLIVAN SIMPSON (LCSW) is a healthcare provider. based in Lewiston, Maine. specializing in CLINICAL SOCIAL WORKER. They hold the professional credentials LCSW. They hold a License No. LC8693 (ME). The NPI Number for SHANE SULLIVAN SIMPSON (LCSW) is 1053471995

Main info

Male
24 Years Of Experience
Accepts Medicare Assignment
Name
SHANE SULLIVAN SIMPSON (LCSW)
NPI
1053471995
Phone
(207) 783-4695
Address
230 BARTLETT ST
Enumeration Date
11 December 2006
Last Update Date
8 July 2007

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2076213750
Graduation Year
2002 (24 years ago)
PAC ID
1456323401
Group Practice PAC ID
2163316548
Professional Enrollment ID
I20040810000727
Address ID
ME043307451AU9XXXXSTXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

1,114 CLINICAL SOCIAL WORKER in ME

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Provider Addresses for SHANE SULLIVAN SIMPSON (LCSW)

  • 230, Bartlett Street, Lewiston, Androscoggin County, Maine, 04240, United States

    LEWISTON, ME 042406578

    Phone: (207) 783-4695

    Type: Location

  • 164, Intervale Road, Upper Gloucester, New Gloucester, Cumberland County, Maine, 04260, United States

    NEW GLOUCESTER, ME 042603812

    Phone: (207) 807-5610

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2004-08-10

PECOS data refreshed: 2026-06-15

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20040810000727IClinical Social WorkerMETBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 04240)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 2163316548View full group profile
NameSpecialtyState
Clinical Social WorkerPA
Clinical Social WorkerME
-ME
Clinical Social WorkerME
Clinical Social WorkerME
Mental Health CounselorME
Mental Health CounselorME
Clinical Social WorkerME
Clinical Social WorkerME

Reviews

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Frequently asked questions

Does SHANE SULLIVAN SIMPSON (LCSW) share an NPI with anyone else?
NPI numbers are unique to each provider or organization — SHANE SULLIVAN SIMPSON (LCSW) uses 1053471995.
Does the file indicate SHANE SULLIVAN SIMPSON (LCSW) is practicing under active NPI?
Directory data currently reports SHANE SULLIVAN SIMPSON (LCSW) as active.
What is SHANE SULLIVAN SIMPSON (LCSW)'s primary classification?
Clinical Social Worker is the headline specialty for SHANE SULLIVAN SIMPSON (LCSW) here. Clinical services aligned with this taxonomy classification.
Where is SHANE SULLIVAN SIMPSON (LCSW) based?
SHANE SULLIVAN SIMPSON (LCSW) is tied to Lewiston, Maine in the data we show; additional addresses may exist on the full record.
How many locations tie to this NPI?
2 practice locations appear in the available data.

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