Active NPI
Marianne Shirley, LCSW
- Clinical Social Worker
- Bangor, ME
National Provider Identifier
1225243454
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LC5106
- Practice address
- 970 Illinois Ave
Bangor, ME 04401-2722 - Phone
- (207) 945-4240
- Fax
- (207) 990-3660
- NPI assigned
- May 11, 2007
- Last updated
- Jul 8, 2007
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | LC5106 | ME | Primary |
Addresses
Primary practice location
970 Illinois Ave
Bangor, ME 04401-2722
Mailing address
1123 Happytown Rd
Ellsworth, ME 04605-3055
Phone (207) 667-6603
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 |
|---|---|---|---|
| LC5106 | ME | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Care Development of Maine | Clinical | 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": "1178841600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1225243454",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1123 HAPPYTOWN RD",
"city": "ELLSWORTH",
"state": "ME",
"postal_code": "046053055",
"telephone_number": "207-667-6603"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "970 ILLINOIS AVE",
"city": "BANGOR",
"state": "ME",
"postal_code": "044012722",
"telephone_number": "207-945-4240",
"fax_number": "207-990-3660"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHIRLEY",
"first_name": "MARIANNE",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-11",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "ME",
"license": "LC5106",
"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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.