Individual provider Active NPI

Danielle Lee Gagnon, LSW-C

  • Case Manager/Care Coordinator
  • Bangor, ME
National Provider Identifier
1134420466
Registry record updated Nov 3, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
License
LSX11070 Issued in ME
Practice address
304 Hancock St Ste 2C
Bangor, ME 04401-6573
Phone
(207) 989-5701
Fax
(207) 989-5720
NPI assigned
Nov 3, 2010
Last updated
Nov 3, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X LSX11070 ME Primary

Addresses

Primary practice location

304 Hancock St Ste 2C
Bangor, ME 04401-6573

Mailing address

304 Hancock St Ste 2C
Bangor, ME 04401-6573
Phone (207) 989-5701

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LSX11070MEMDCase Manager/Care Coordinator

Practice roles

OrganizationSpecialtyStatusNew patients
Families United Past Accepting new patients

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": "1288742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1288742400000",
    "number": "1134420466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "304 HANCOCK ST STE 2C",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044016573",
            "telephone_number": "207-989-5701",
            "fax_number": "207-989-5720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "304 HANCOCK ST STE 2C",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044016573",
            "telephone_number": "207-989-5701",
            "fax_number": "207-989-5720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAGNON",
        "first_name": "DANIELLE",
        "middle_name": "LEE",
        "credential": "LSW-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-11-03",
        "last_updated": "2010-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "ME",
            "license": "LSX11070",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Nov 3, 2010; 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.