Maura Tukey Clark, MSW, LCSW
Individual provider Active NPI Clinical Social Worker · New Gloucester, ME
NPI 1083632491 · NPPES record last updated Nov 4, 2010
Key facts
- NPI
- 1083632491
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- LC11088 (ME)
- Practice address
- 180 Hatch Rd
New Gloucester, ME 04260-3663 - Phone
- (207) 926-5021
- NPI assigned
- Jul 17, 2006
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LC11088 | ME | MD | Mental Health Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | LC11088 | ME | Yes |
| Mental Health Counselor | 101YM0800X | LC11088 | ME |
Addresses
Primary practice location
180 Hatch Rd
New Gloucester, ME 04260-3663
Mailing address
180 Hatch Rd
New Gloucester, ME 04260-3663
Phone (207) 926-5021
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 31686 | Other | MA | HEALTH NEW ENGLAND |
Other providers in New Gloucester, ME
- CH MH Services (Me), LLC
- Patrick Andrew D'Amboise
- Brian M. Davis
- Susan E Delaney
- Travis Dyer
- Echo Center
All providers in New Gloucester, ME · Clinical Social Worker in Maine
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 4, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.