Individual provider Active NPI

Susan Ann Brochu, LCSW

  • Clinical Social Worker
  • Augusta, ME
National Provider Identifier
1144311135
Registry record updated Oct 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LC7597 Issued in ME
Practice address
11 Parkwood Dr
Augusta, ME 04330-6252
Phone
(207) 441-6624
NPI assigned
Sep 27, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LC7597 ME Primary

Addresses

Primary practice location

11 Parkwood Dr
Augusta, ME 04330-6252

Mailing address

11 Parkwood Dr
Augusta, ME 04330-6252
Phone (207) 441-6624

Other identifiers 1

IdentifierTypeStateIssuer
205070099MedicaidME

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
I20041123000826 ME Practitioner - Clinical Social Worker 5395700942 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2002
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

49 Oak St
Augusta, ME 04330-5118
Phone (207) 441-6624

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
LC7597MEMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Sweetser CurrentSince Nov 5, 2012 Accepting new patients
Thepleasantoak, Inc Clinical CurrentSince Jun 14, 2010 Accepting new patients
The Maine Children'S Home for Little Wanderers PastSince Feb 9, 2012 Accepting new patients

Locations

11 Parkwood Dr
Augusta, ME 04330
Phone (207) 441-6624

49 Oak St
Augusta, ME 04330
Phone (207) 399-5589

28 Sweetser Dr
Belfast, ME 04915
Phone (207) 284-5981

50 Moody St
Saco, ME 04072
Phone (207) 284-5981

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728432000000",
    "number": "1144311135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 PARKWOOD DR",
            "city": "AUGUSTA",
            "state": "ME",
            "postal_code": "043306252",
            "telephone_number": "207-441-6624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 PARKWOOD DR",
            "city": "AUGUSTA",
            "state": "ME",
            "postal_code": "043306252",
            "telephone_number": "207-441-6624"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROCHU",
        "first_name": "SUSAN",
        "middle_name": "ANN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-27",
        "last_updated": "2024-10-09",
        "certification_date": "2024-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ME",
            "license": "LC7597",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "205070099",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Augusta, ME

Sources for this page

Verify at the official NPI Registry.