Individual provider Active NPI

Mark E. Thurlow, LCSW

  • Clinical Social Worker
  • Portland, ME
National Provider Identifier
1003257825
Registry record updated Jun 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LC15393 Issued in ME
Practice address
53 Baxter Blvd Ste 3
Portland, ME 04101-1827
Phone
(603) 883-0005
NPI assigned
Jul 9, 2013
Last updated
Jun 17, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 17, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X MC14221 ME
Clinical Social Worker 1041C0700X LC15393 ME Primary

Addresses

Primary practice location

53 Baxter Blvd Ste 3
Portland, ME 04101-1827

Mailing address

21 North Rd
Winn, ME 04495-5329
Phone (207) 738-3032

Other practice location 1

21 North Rd
Winn, ME 04495-5329
Phone (207) 738-3032

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160504000855 ME Practitioner - Clinical Social Worker 4183923600

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LC15393MEMDClinical Social Worker
MC14221MEMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Pine Tree Urgent Care LLC CurrentSince Aug 25, 2025 Accepting new patients

Locations

557 Hammond St
Bangor, ME 04401
Phone (207) 239-9757

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1373328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781654400000",
    "number": "1003257825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 NORTH RD",
            "city": "WINN",
            "state": "ME",
            "postal_code": "044955329",
            "telephone_number": "207-738-3032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "53 BAXTER BLVD STE 3",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041011827",
            "telephone_number": "603-883-0005"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "21 North Rd",
            "address_purpose": "LOCATION",
            "city": "Winn",
            "state": "ME",
            "postal_code": "044955329",
            "country_code": "US",
            "telephone_number": "207-738-3032",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THURLOW",
        "first_name": "MARK",
        "middle_name": "E.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-07-09",
        "last_updated": "2026-06-17",
        "certification_date": "2026-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ME",
            "license": "MC14221",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ME",
            "license": "LC15393",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, ME

Sources for this page

Verify at the official NPI Registry.