Individual provider Active NPI

Diane Rognerud, LCSW

  • Clinical Social Worker
  • Brunswick, ME
National Provider Identifier
1427008879
Registry record updated May 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LC3157 Issued in ME
Practice address
114 Maine Street 2ND Floor #3
Brunswick, ME 04011-2029
Phone
(207) 798-1924
NPI assigned
May 10, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 20, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LC3157 ME Primary

Addresses

Primary practice location

114 Maine Street 2ND Floor #3
Brunswick, ME 04011-2029

Mailing address

214 Raymond Rd
Brunswick, ME 04011-7361

Other identifiers 1

IdentifierTypeStateIssuer
431536299MedicaidME

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)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Bluesage Therapies Inc. 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1147219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1558310400000",
    "number": "1427008879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "214 RAYMOND RD",
            "city": "BRUNSWICK",
            "state": "ME",
            "postal_code": "040117361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 MAINE STREET 2ND FLOOR #3",
            "city": "BRUNSWICK",
            "state": "ME",
            "postal_code": "040112029",
            "telephone_number": "207-798-1924"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROGNERUD",
        "first_name": "DIANE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-10",
        "last_updated": "2019-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ME",
            "license": "LC3157",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "431536299",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brunswick, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.