Individual provider Active NPI

Mollie Caitlin Gunnoe, LCSW, LADC

  • Clinical Social Worker
  • Portland, ME
National Provider Identifier
1528577301
Registry record updated Apr 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LC20774 Issued in ME
Practice address
22 Bramhall St
Portland, ME 04102-3175
Phone
(207) 662-4807
NPI assigned
Sep 25, 2017
Last updated
Apr 5, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2023

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X SC60864092 WA
Addiction (Substance Use Disorder) Counselor 101YA0400X LC8055 ME
Clinical Social Worker 1041C0700X LW61196449 WA
Student in an Organized Health Care Education/Training Program 390200000X
Clinical Social Worker 1041C0700X LC20774 ME Primary

Addresses

Primary practice location

22 Bramhall St
Portland, ME 04102-3175

Mailing address

22 Bramhall St
Portland, ME 04102-3175

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
I20230427002355 ME Practitioner - Clinical Social Worker 0648635524 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Spurwink Services IncorporatedGroup PAC ID 7810026945, 87 clinicians

Practice addresses (Care Compare)

901 Washington Ave
Suite 100
Portland, ME 04103-2842
Phone (207) 871-1200

Merit-based Incentive Payment System (MIPS)

Final score
97.93 of 100Reported as apm
Quality
83.31
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SC60864092WAMDCounselor
LC8055MEMDAddiction (Substance Use Disorder) Counselor
LC20774MEMDClinical Social Worker
LW61196449WAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Spurwink Services Incorporated CurrentSince Dec 20, 2023 Accepting new patients
Spurwink Services Incorporated PastSince Dec 20, 2023 Accepting new patients
Catholic Community Services of Western Washington Past Accepting new patients

Locations

139 State St
#1
Bangor, ME 04401

62 Elm St
Portland, ME 04101
Phone (207) 535-2096

901 Washington Ave
Ste 100
Portland, ME 04103
Phone 20787112112145

9 Hillcrest Ave
Randolph, ME 04346
Phone (207) 582-9205

Organizations & group practices 3

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": "1506297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680652800000",
    "number": "1528577301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 BRAMHALL ST",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041023175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 BRAMHALL ST",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041023175",
            "telephone_number": "207-662-4807"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUNNOE",
        "first_name": "MOLLIE",
        "middle_name": "CAITLIN",
        "credential": "LCSW, LADC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-25",
        "last_updated": "2023-04-05",
        "certification_date": "2023-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "WA",
            "license": "SC60864092",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "ME",
            "license": "LC8055",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "LW61196449",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ME",
            "license": "LC20774",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, ME

Sources for this page

Verify at the official NPI Registry.