Individual provider Active NPI

Amber Gahagan, LCSW

  • School Social Worker
  • Lagrange, ME
National Provider Identifier
1255768701
Registry record updated Sep 30, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
School Social WorkerTaxonomy code 1041S0200X
License
LC5168 Issued in ME
Practice address
22 Howland Rd
Lagrange, ME 04453-5321
Phone
(207) 943-7317
Fax
(207) 943-5314
NPI assigned
Sep 30, 2013
Last updated
Sep 30, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
School Social Worker 1041S0200X LC5168 ME Primary

Addresses

Primary practice location

22 Howland Rd
Lagrange, ME 04453-5321

Mailing address

20 Howland Rd
Lagrange, ME 04453-5321
Phone (207) 943-7317

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
I20160216000566 ME Practitioner - Clinical Social Worker 9739483520 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
SweetserGroup PAC ID 8325946213, 138 clinicians

Practice addresses (Care Compare)

50 Moody St
Saco, ME 04072-1536

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LC5168MEMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Sweetser CurrentSince Nov 22, 2015 Accepting new patients

Locations

187 Exchange St
Bangor, ME 04401
Phone (207) 990-0605

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

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

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": "1380499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1380499200000",
    "number": "1255768701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 HOWLAND RD",
            "city": "LAGRANGE",
            "state": "ME",
            "postal_code": "044535321",
            "telephone_number": "207-943-7317",
            "fax_number": "207-943-5314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 HOWLAND RD",
            "city": "LAGRANGE",
            "state": "ME",
            "postal_code": "044535321",
            "telephone_number": "207-943-7317",
            "fax_number": "207-943-5314"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAHAGAN",
        "first_name": "AMBER",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-30",
        "last_updated": "2013-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041S0200X",
            "taxonomy_group": "",
            "desc": "Social Worker, School",
            "state": "ME",
            "license": "LC5168",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lagrange, ME

Sources for this page

Verify at the official NPI Registry.