Individual provider Active NPI

Brenna Coughlin, L.C.S.W

  • Clinical Social Worker
  • Topsham, ME
National Provider Identifier
1194977371
Registry record updated Sep 16, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LC8502 Issued in ME
Practice address
63 Elm St Ste a
Suite 1
Topsham, ME 04086-1424
Phone
(207) 751-8518
NPI assigned
Oct 19, 2008
Last updated
Sep 16, 2013By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 16, 2013

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 LC8502 ME Primary

Addresses

Primary practice location

63 Elm St Ste a
Suite 1
Topsham, ME 04086-1424

Mailing address

63 Elm St Ste a
Suite 1
Topsham, ME 04086-1424
Phone (207) 751-8518

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
I20111128000405 ME Practitioner - Clinical Social Worker 2769656933 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

63 Elm St
Suite a
Topsham, ME 04086-1424
Phone (207) 751-8518

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Coughlin Counseling, LLC Clinical CurrentSince Aug 4, 2011 Accepting new patients

Locations

63 Elm St
Ste A
Topsham, ME 04086
Phone (207) 373-0400

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": "1224374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379289600000",
    "number": "1194977371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "63 ELM ST STE A",
            "address_2": "SUITE 1",
            "city": "TOPSHAM",
            "state": "ME",
            "postal_code": "040861424",
            "telephone_number": "207-751-8518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "63 ELM ST STE A",
            "address_2": "SUITE 1",
            "city": "TOPSHAM",
            "state": "ME",
            "postal_code": "040861424",
            "telephone_number": "207-751-8518"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COUGHLIN",
        "first_name": "BRENNA",
        "name_prefix": "Ms.",
        "credential": "L.C.S.W",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-10-19",
        "last_updated": "2013-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ME",
            "license": "LC8502",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Topsham, ME

Sources for this page

Verify at the official NPI Registry.