KAREN M VERDELLI LCSW
NPI 1275793606
Social Worker - Clinical in Baileyville, ME
NPI Status: Active since June 10, 2008
Contact Information
73 WASHINGTON ST
BAILEYVILLE, ME
ZIP 04694
Phone: (207) 318-8778
Fax: (207) 222-4013
- Individual
- Female
- Years of Experience 20
- Social Worker
- Clinical
- Accepts Insurance
- Accepts Medicare Approved Payment
- PECOS Enrolled
About KAREN VERDELLI
This page provides the complete NPI Profile along with additional information for Karen Verdelli, a provider established in Baileyville, Maine with a medical specialization in Social Worker, focusing in clinical and more than 20 years of experience. She graduated from University Of New England, College Of Osteo Medicine in 2006. The healthcare provider is registered in the NPI registry with number 1275793606 assigned on June 2008. The practitioner's primary taxonomy code is 1041C0700X with license number LC11572 (ME). The provider is registered as an individual and her NPI record was last updated one year ago.
- NPI
- 1275793606
- Provider Name
- KAREN M VERDELLI LCSW
- Gender
- Female
- Entity Type
- Individual
- Location Address
- 73 WASHINGTON ST BAILEYVILLE, ME 04694
- Location Phone
- (207) 318-8778
- Location Fax
- (207) 222-4013
- Mailing Address
- 73 WASHINGTON ST BAILEYVILLE, ME 04694
- Mailing Phone
- (207) 318-8778
- Mailing Fax
- (207) 222-4013
- Medical School Name
- UNIVERSITY OF NEW ENGLAND, COLLEGE OF OSTEO MEDICINE
- Graduation Year
- 2006
- Is Sole Proprietor?
- Yes
- Enumeration Date
- 06-10-2008
- Last Update Date
- 02-02-2024
- Code Navigator
A clinical social worker like Karen Verdelli is licensed to diagnose and treat mental, behavioral, and emotional disorders. A clinical social worker helps patients develop strategies to change behavior or cope with difficult situations and refer patients to other resources or services, such as support groups or other mental health professionals.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Social Worker Clinical
- Taxonomy Code
- 1041C0700X
- Type
- Behavioral Health & Social Service Providers
- License No.
- LC11572
- License State
- ME
- Taxonomy Description
- A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Anthem Bronze Access Blue New England HMO 5000/10%/8000 w/HSA - HMO
- Anthem Bronze Access Blue New England HMO 5000/20%/8000 w/HSA - HMO
- Anthem Bronze Access Blue New England HMO 6500/30%/9200 Value - HMO
- Anthem Bronze Access Blue New England HMO 7000/50%/8000 w/HSA - HMO
- Anthem Bronze Access Blue New England HMO 8500/50%/9200 - HMO
- Anthem Gold Access Blue New England HMO 1000/20%/7500 - HMO
- Anthem Gold Access Blue New England HMO 2000/0%/6500 RxD - HMO
- Anthem Gold Access Blue New England HMO 2000/10%/4600 w/HSA - HMO
- Anthem Gold Access Blue New England HMO 2000/10%/7500 - HMO
- Anthem Gold Access Blue New England HMO 2000/20%/4600 w/HSA - HMO
- Anthem Gold Access Blue New England HMO 3000/0%/5500 RxD - HMO
- Anthem Gold Access Blue New England HMO 500/25%/7000 - HMO
- Anthem Platinum Access Blue New England HMO 250/10%/3500 - HMO
- Anthem Silver Access Blue New England HMO 2000/30%/9000 Value - HMO
- Anthem Silver Access Blue New England HMO 3000/20%/8500 - HMO
- Anthem Silver Access Blue New England HMO 3000/30%/9000 Value - HMO
- Anthem Silver Access Blue New England HMO 3500/20%/7250 w/HSA - HMO
- Anthem Silver Access Blue New England HMO 4000/0%/8500 - HMO
- Anthem Silver Access Blue New England HMO 4000/0%/8500 RxD - HMO
- Anthem Silver Access Blue New England HMO 4000/10%/7250 w/HSA - HMO
- NH Local Choice HMO Bronze 8000 - HMO
- NH Local Choice HMO Gold - HMO
- NH Local Choice HMO Gold 1400 - HMO
- NH Local Choice HMO HSA Bronze 6000 - HMO
- NH Local Choice HMO Silver 3500 - HMO
- NH Local Choice HMO Silver 5000 - HMO
- NH Local HMO Bronze 7500 Standard - HMO
- NH Local HMO Gold 1500 Standard - HMO
- NH Local HMO Silver 5000 Standard - HMO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Medicare Participation & PECOS Enrollment Status
Karen Verdelli is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.
Karen Verdelli is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging and Durable Medical Equipment (DME).
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
PECOS PAC ID: 1759539539
What is the PECOS Associate Control ID?
A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.PECOS Enrollment ID: I20120920000146
What is the Provider Enrollment ID?
The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.Accepts Medicare Assignment? Yes
What does it mean "accepts medicare assignment"?
When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): No
Eligible to Order or Refer Power Mobility Devices: No
Areas of Expertise
The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.
Psychotherapy, 1 hour
Psychotherapy is a therapeutic interaction or treatment between a trained professional and a patient. In a 1-hour session, you'll talk about your feelings, thoughts, and behaviors to help identify and manage mental health issues. This process aids in personal growth, healing, and improved well-being.
This service was performed 96 times for 13 patientsPhysician Visit Costs
The typical physician office visit costs for Medicare beneficiaries in this area are: $0 for a new patient copayment and $16.68 for an established patient copayment.
The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.
For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.
The prices below reflect the costs for new and established patients in the 04694 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is NA
- Average New Patient Price $0
- Minimum New Patient Price $53.26
- Maximum New Patient Price $162.77
- Average New Patient Copayment $0
- Minimum New Patient Copayment $13.31
- Maximum New Patient Copayment $40.69
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99213
- Average Established Patient Price $66.74
- Minimum Established Patient Price $16.9
- Maximum Established Patient Price $132.79
- Average Established Patient Copayment $16.68
- Minimum Established Patient Copayment $4.22
- Maximum Established Patient Copayment $33.19
* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 2 | 7 | 5 | 7 | 9 | 3 | 6 | 0 | 6 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 2 | 14 | 5 | 14 | 9 | 6 | 6 | 0 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 2 + 1 + 4 + 5 + 1 + 4 + 9 + 6 + 6 + 0 + 24 = 64 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 70 - 64 = 6 | 6 | ||||||||
The NPI number 1275793606 is valid because the calculated check digit 6 using the Luhn validation algorithm matches the last digit of the original NPI number.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1275793606, enumerated in the NPI registry as an "individual" on June 10, 2008
The provider is located at 73 Washington St Baileyville, Me 04694 and the phone number is (207) 318-8778
The provider's speciality is Social Worker with taxonomy code 1041C0700X with a focus in Clinical
The provider has more than 20 years of experience. She graduated from University Of New England, College Of Osteo Medicine in 2006.
The provider might be accepting Accepts: Anthem Blue Cross and Blue Shield and Harvard. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
Yes, as of June 20, 2025 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary the provider is eligible to order or refer: Part B Clinical Laboratory and Imaging and Durable Medical Equipment (DME).
Medicare beneficiaries should expect a typical cost of $0 with an average copayment of $0 for new patient appointments. Established patients should expect a typical charge of $66.74 and an average copayment of 16.68. Please review your insurance plan or contact the provider directly to determine your specific costs.
The most common procedures or services performed by this practitioner are: Psychotherapy, 1 hour.
This NPI record was last updated on June 10, 2008. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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