BETHANY PETERSON (LCSW) – Clinical Social Worker, NPI 1861875734

BETHANY PETERSON (LCSW) is a healthcare provider. based in Windham, Maine. specializing in CLINICAL SOCIAL WORKER. They hold the professional credentials LCSW. They hold a License No. LC17411 (ME). The NPI Number for BETHANY PETERSON (LCSW) is 1861875734

Main info

Female
Sole Proprietor
11 Years Of Experience
Accepts Medicare Assignment
Name
BETHANY PETERSON (LCSW)
NPI
1861875734
Phone
(207) 651-5880
Address
86 TANDBERG TRL
Enumeration Date
9 July 2015
Last Update Date
4 December 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8004343000
Graduation Year
2015 (11 years ago)
PAC ID
3678802170
Group Practice PAC ID
8325946213
Professional Enrollment ID
I20190909002820
Address ID
ME040721536SA50XXXSTXX300
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience44
Completeness75
Years active:10State licenses:1Digital endpointsOther names

1,104 CLINICAL SOCIAL WORKER in ME

Provider Addresses for BETHANY PETERSON (LCSW)

  • 86 TANDBERG TRL

    WINDHAM, ME 040625841

    Phone: (207) 651-5880

    Type: Mailing

  • 647 US ROUTE 1 STE 302

    YORK, ME 039091689

    Phone: (207) 651-5880

    Type: Location

  • 59 OAK LN

    WELLS, ME 040907023

    Phone: (207) 651-5880

    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: 2019-09-09

PECOS data refreshed: 2026-05-27

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
I20190909002820IClinical 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 04062)

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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: 8325946213View full group profile

Reviews

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Frequently asked questions

What unique ID ties claims to BETHANY PETERSON (LCSW)?
NPI 1861875734 is assigned to BETHANY PETERSON (LCSW) under the national enumeration system.
Is BETHANY PETERSON (LCSW)'s enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
What kind of provider is BETHANY PETERSON (LCSW)?
The page reflects Clinical Social Worker for BETHANY PETERSON (LCSW). Clinical services aligned with this taxonomy classification.
What location shows for BETHANY PETERSON (LCSW)?
We surface Windham, Maine for BETHANY PETERSON (LCSW) based on available NPPES addresses.
How can I contact BETHANY PETERSON (LCSW)?
Phone or fax may appear on the official NPI record when supplied — verify before relying on them.

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