Active NPI
Cindy R McLellan, LSW
- Social Worker
- Bangor, ME
National Provider Identifier
1205136058
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- LS4209
- Practice address
- 304 Hancock St
Bangor, ME 04401-6573 - Phone
- (207) 989-5701
- Fax
- (207) 989-5720
- NPI assigned
- Oct 27, 2010
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | LS4209 | ME | Primary |
Addresses
Primary practice location
304 Hancock St
Bangor, ME 04401-6573
Mailing address
304 Hancock St
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
| License | State | Type | Specialty |
|---|---|---|---|
| LS4209 | ME | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1288137600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1288137600000",
"number": "1205136058",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "304 HANCOCK ST",
"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",
"city": "BANGOR",
"state": "ME",
"postal_code": "044016573",
"telephone_number": "207-989-5701",
"fax_number": "207-989-5720"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCLELLAN",
"first_name": "CINDY",
"middle_name": "R",
"name_prefix": "Mrs.",
"credential": "LSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-10-27",
"last_updated": "2010-10-27",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "ME",
"license": "LS4209",
"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 Oct 27, 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.