Organization Active NPI

Lifeworks of Maine LLC

  • Clinical Social Worker
  • Bangor, ME
National Provider Identifier
1053887737
Registry record updated Oct 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
LIFEWORKS OF MAINE LLC
Practice address
444 Stillwater Ave Ste 103
Bangor, ME 04401-3500
Phone
(120) 307-7886
NPI assigned
Oct 19, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2018

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

Authorized official

Name
Dr. Heather L Macduffie, PHD LCSW
Title
Sole Member
Phone
(207) 307-7886

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

444 Stillwater Ave Ste 103
Bangor, ME 04401-3500

Mailing address

444 Stillwater Ave Ste 103
Bangor, ME 04401-3500
Phone (207) 307-7886

Other identifiers 1

IdentifierTypeStateIssuer
2469600000MedicaidME

National Provider Directory

National Provider Directory

Locations

444 Stillwater Ave
Ste 103
Bangor, ME 04401
Phone (207) 307-7886

NPI Registry JSON

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

{
    "created_epoch": "1539907200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1539907200000",
    "number": "1053887737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "444 STILLWATER AVE STE 103",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044013500",
            "telephone_number": "207-307-7886",
            "fax_number": "207-433-1241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "444 STILLWATER AVE STE 103",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044013500",
            "telephone_number": "120-307-7886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFEWORKS OF MAINE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-19",
        "last_updated": "2018-10-19",
        "status": "A",
        "authorized_official_last_name": "MACDUFFIE",
        "authorized_official_first_name": "HEATHER",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "SOLE MEMBER",
        "authorized_official_telephone_number": "207-307-7886",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2469600000",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bangor, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.