Individual provider Active NPI

Samantha Brent, LCSW

  • Clinical Social Worker
  • Bangor, ME
National Provider Identifier
1184176638
Registry record updated Nov 1, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LC16342 Issued in ME
Practice address
268 Stillwater Ave
Bangor, ME 04401-3945
Phone
(207) 973-6100
Fax
(207) 973-6107
NPI assigned
Nov 1, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2016

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 LC16342 ME Primary

Addresses

Primary practice location

268 Stillwater Ave
Bangor, ME 04401-3945

Mailing address

268 Stillwater Ave
Bangor, ME 04401-3945
Phone (207) 973-6100

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
I20161207002592 ME Practitioner - Clinical Social Worker 1951681097 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Health Affiliates Maine, LLCGroup PAC ID 1951594076, 169 clinicians

Practice addresses (Care Compare)

306 Rodman Rd
Auburn, ME 04210-3830
Phone (207) 333-3278

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LC16342MEMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Acadia Healthcare, Inc CurrentSince Sep 9, 2018 Accepting new patients
Acadia Hospital Corp CurrentSince Oct 22, 2016 Accepting new patients
Health Affiliates Maine, LLC CurrentSince Mar 15, 2020 Accepting new patients

Locations

306 Rodman Rd
Auburn, ME 04210
Phone (207) 333-3278

268 Stillwater Ave
Bangor, ME 04401
Phone (207) 973-6470

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": "1477958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477958400000",
    "number": "1184176638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "268 STILLWATER AVE",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044013945",
            "telephone_number": "207-973-6100",
            "fax_number": "207-973-6107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "268 STILLWATER AVE",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044013945",
            "telephone_number": "207-973-6100",
            "fax_number": "207-973-6107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRENT",
        "first_name": "SAMANTHA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-11-01",
        "last_updated": "2016-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ME",
            "license": "LC16342",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bangor, ME

Sources for this page

Verify at the official NPI Registry.