CARLA STOCKDALE

NPI 1801223573, individual, Winthrop, ME, Social Worker, Clinical

Evidence tier

informational

score 32 of 100, rank 10677, $7.5M at stake

National provider registry

From the CMS NPPES Registry, refreshed daily.

Name	CARLA STOCKDALE
Type	Individual
Status	Active
NPI issued	September 26, 2013, last updated September 26, 2013
Practice location	149 MAIN ST, SUITE 2A, Winthrop, ME 04364-1486, 207-377-2111
Specialties	Social Worker, Clinical (1041C0700X, primary, license LC5022 ME)

Procedures billed

The specific codes behind the dollars. Medicaid figures come from T-MSIS (2018 to 2024) and are compared with every other provider billing the same code; Medicare figures come from the 2024 physician and supplier file and compare this provider's submitted charge with what Medicare allowed, against the usual ratio for that code.

Medicaid, largest codes

code	what it is	paid	share	per patient-month	typical	rank among providers
H2030	Mental health clubhouse services per 15 min	$19.4M	100%	$933	$770 (top 5% from $2K)	68th percentile
H2000	Medicaid service code	$26K	0%	$79	$173 (top 5% from $548)	13th percentile

In this area

10 providers in ME carry an indicator in the public record, with $12.1M at stake between them. The most common is more hours than a day holds, on 9 of them, followed by part of a provider network on 1.

tier	provider	at stake	why
3	AFFINITY CARE OF MAINE LLC South Portland, ME, ranked 1675	$596	Part of provider network D1-00113, ranked 113 nationally.
5	KATHERINE MARBLE Auburn, ME, ranked 9801	$9.4M	Medicaid dollars per patient on code T1013 ($425 per patient-month) sit in the top 5% of every provider billing that code. 77% of Medicaid dollars are on codes with a history of abuse.
5	KIMBERLY LOIKA-SMITH South Portland, ME, ranked 10395	$190K	Medicaid dollars per patient on code H2012 ($5129 per patient-month) sit in the top 5% of every provider billing that code.
5	JAMIE ROSE South Portland, ME, ranked 10441	$125K	Medicaid dollars per patient on code H2012 ($4556 per patient-month) sit in the top 5% of every provider billing that code.
5	KAREN BACKMAN Westbrook, ME, ranked 10587	$873K	100% of Medicaid dollars are on codes with a history of abuse.
5	JACQUELYN POULIN Presque Isle, ME, ranked 10654	$116K	100% of Medicaid dollars are on codes with a history of abuse.
5	CHERYL DAVIS Augusta, ME, ranked 11087	$837K
5	LINDA RILEY Farmington, ME, ranked 11373	$297K

All 10 in ME

Recent enforcement in ME

All releases

Department of Justice and HHS-OIG releases for this state, newest first. Each opens in a new tab.

DOJComplaint filedJun 30, 2025

Lewiston Man Charged with Identity Theft and Fraud Charges as Part of National Health Care Fraud Takedown

Dobie was charged by complaint with aggravated identity theft, false statements relating to health care matters, and unlawful use of SNAP benefits in connection with an alleged scheme to defraud Medicaid.

DOJCivil settlementFeb 14, 2025

Saint Vincents Catholic Medical Centers of New York Agrees to Pay $29M to Resolve Alleged False Claims Act Violations

Saint Vincent knowingly retained erroneously inflated capitated payments from the Defense Health Agency under the Uniformed Services Family Health Plan, concealed the overpayments, continued submitting invoices at inflated rates, and conspired to avoid repaying the funds.

DOJSentencedJan 24, 2024

Corinna Counselor Ordered to Pay MaineCare $13,087.62 for Submitting Bogus Treatment Records

Between April and December 2020, McKinney falsified appointment details and session notes in therapy service records and used the falsified records to bill and receive funds from MaineCare.

DOJSentencedJan 5, 2024

Woodville Woman Ordered to Repay $103,596.91 after Committing Yearslong Fraud to Obtain Benefits

Austin-Kimball lied to the Social Security Administration and Maine DHHS about her husband's presence in her household and failed to report alimony payments to fraudulently appear eligible for SSI, MaineCare, and SNAP benefits for herself and her minor child.

Referral packet

The packet is a draft for a reviewer. It reads every public record behind this case, states what the records show with a citation for each finding, names the regulation each finding relates to, and lists the ordinary explanations to rule out first. It never asserts intent.

Ask this case

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