Douglas E Patrick, LCSW, JD

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LC7181 Issued in ME

Practice address

52 Tranquil LN
Freeport, ME 04032-6905

Phone

(207) 865-3560

NPI assigned

Nov 13, 2010

Last updated

Aug 30, 2022By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Clinical Social Worker

Education

Other, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Juris Doctor

State licenses

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

{
    "created_epoch": "1289606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661817600000",
    "number": "1336440973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "52 TRANQUIL LN",
            "city": "FREEPORT",
            "state": "ME",
            "postal_code": "040326905",
            "telephone_number": "207-650-4005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "52 TRANQUIL LN",
            "city": "FREEPORT",
            "state": "ME",
            "postal_code": "040326905",
            "telephone_number": "207-865-3560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATRICK",
        "first_name": "DOUGLAS",
        "middle_name": "E",
        "name_prefix": "Mr.",
        "credential": "LCSW, JD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-11-13",
        "last_updated": "2022-08-30",
        "certification_date": "2022-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ME",
            "license": "LC7181",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Freeport, ME
• Providers in Freeport, ME by specialty
• Clinical Social Worker in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.