Azure Marie Proctor, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LC13101 Issued in ME

Practice address

32 Sherwood Dr
Auburn, ME 04210-5320

Phone

(207) 783-8526

NPI assigned

Aug 18, 2009

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Ms. Azure Marie Mahunik Former name

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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

• Health Affiliates Maine, LLC

  • Community/Behavioral Health Agency
  • Auburn, ME
  • NPI 1932413556
  Medicare reassignment NPD

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

{
    "created_epoch": "1250553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1311552000000",
    "number": "1033341417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32 SHERWOOD DR",
            "city": "AUBURN",
            "state": "ME",
            "postal_code": "042105320",
            "telephone_number": "207-783-8526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32 SHERWOOD DR",
            "city": "AUBURN",
            "state": "ME",
            "postal_code": "042105320",
            "telephone_number": "207-783-8526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROCTOR",
        "first_name": "AZURE",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-08-18",
        "last_updated": "2011-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ME",
            "license": "MC12195",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ME",
            "license": "LC13101",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AZURE",
            "last_name": "MAHUNIK",
            "middle_name": "MARIE",
            "prefix": "MS.",
            "credential": "LMSW-CC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Scott Pratt, MS ATC LAT
• Premier Advocate and Support Services of New England LLC (PASS New England)
• Julie Ann Preston, COTA/L
• Prime Care Maine LLC
• Pro Vision Center,Inc
• Ryan F Prosser
• Michael Puchacz
• Mindy L Puri, PA-C
• Terri Quatrano Simpson, LCSW
• Cole Jospeh Quirion, MS, LCPC-C

• Clinical Social Worker in Auburn, ME
• Providers in Auburn, ME by specialty
• Clinical Social Worker in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.