Active NPI
Mindy Reeves, LMSW-CC/CADC
- Clinical Social Worker
- Bangor, ME
National Provider Identifier
1508439746
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- MC20647
- Practice address
- 268 Stillwater Ave
Bangor, ME 04401-3945 - Phone
- (207) 973-6100
- NPI assigned
- Jul 23, 2021
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | CAC7692 | ME | |
| Clinical Social Worker | 1041C0700X | MC20647 | ME | Primary |
Addresses
Primary practice location
268 Stillwater Ave
Bangor, ME 04401-3945
Mailing address
268 Stillwater Ave
Bangor, ME 04401-3945
Phone (207) 973-6100
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 |
|---|---|---|---|
| CAC7692 | ME | MD | Addiction (Substance Use Disorder) Counselor |
| MC20647 | ME | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1626998400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1634774400000",
"number": "1508439746",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "268 STILLWATER AVE",
"city": "BANGOR",
"state": "ME",
"postal_code": "044013945",
"telephone_number": "207-973-6100"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "268 STILLWATER AVE",
"city": "BANGOR",
"state": "ME",
"postal_code": "044013945",
"telephone_number": "207-973-6100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REEVES",
"first_name": "MINDY",
"credential": "LMSW-CC/CADC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-07-23",
"last_updated": "2021-10-21",
"certification_date": "2021-10-21",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "ME",
"license": "CAC7692",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "ME",
"license": "MC20647",
"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 Oct 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.