Organization Active NPI

Thepleasantoak, Inc

  • Clinical Social Worker
  • Augusta, ME
National Provider Identifier
1275923369
Registry record updated Oct 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LC7597 Issued in ME
Legal business name
THEPLEASANTOAK, INC
Practice address
11 Parkwood Dr
Augusta, ME 04330-6252
Phone
(207) 441-6624
NPI assigned
Jan 28, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2024

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

Authorized official

Name
Susan A Brochu, LCSWNPI 1144311135
Title
Licensed Clinical Social Worker
Phone
(207) 441-6624

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X LC7597 ME Primary

Addresses

Primary practice location

11 Parkwood Dr
Augusta, ME 04330-6252

Mailing address

11 Parkwood Dr
Augusta, ME 04330-6252
Phone (207) 441-6624

Other identifiers 1

IdentifierTypeStateIssuer
ME1038OtherMEME1038 PCAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150422000076 ME Part B Supplier - Clinic/Group Practice 1456679521 Receives reassigned benefits from 1 practitioner
Practice locations: Augusta, ME

National Provider Directory

National Provider Directory

Locations

11 Parkwood Dr
Augusta, ME 04330
Phone (207) 441-6624

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1422403200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728432000000",
    "number": "1275923369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 PARKWOOD DR",
            "city": "AUGUSTA",
            "state": "ME",
            "postal_code": "043306252",
            "telephone_number": "207-441-6624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 PARKWOOD DR",
            "city": "AUGUSTA",
            "state": "ME",
            "postal_code": "043306252",
            "telephone_number": "207-441-6624"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THEPLEASANTOAK, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-28",
        "last_updated": "2024-10-09",
        "certification_date": "2024-10-09",
        "status": "A",
        "authorized_official_last_name": "BROCHU",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "LICENSED CLINICAL SOCIAL WORKER",
        "authorized_official_telephone_number": "207-441-6624",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "ME",
            "license": "LC7597",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ME1038 PCAN",
            "identifier": "ME1038",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Augusta, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.