Individual provider Active NPI

Hollie Rae Brewer-Cushman, LCSW

  • Clinical Social Worker
  • Scarborough, ME
National Provider Identifier
1548045982
Registry record updated Sep 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LC21162 Issued in ME
Practice address
71 US Route 1 Ste E
Scarborough, ME 04074-7168
Phone
(207) 773-9931
Fax
(207) 879-5576
NPI assigned
Aug 25, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2023

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 LC21162 ME Primary

Addresses

Primary practice location

71 US Route 1 Ste E
Scarborough, ME 04074-7168

Mailing address

96 Pine Grove LN
Etna, ME 04434-3564
Phone (207) 991-1758

Other names 1

  • Ms. Hollie Rae Brewer Former name

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
I20231026002734 ME Practitioner - Clinical Social Worker 4486000437 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LC21162MEMDClinical Social Worker

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": "1692921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694736000000",
    "number": "1548045982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "96 PINE GROVE LN",
            "city": "ETNA",
            "state": "ME",
            "postal_code": "044343564",
            "telephone_number": "207-991-1758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "71 US ROUTE 1 STE E",
            "city": "SCARBOROUGH",
            "state": "ME",
            "postal_code": "040747168",
            "telephone_number": "207-773-9931",
            "fax_number": "207-879-5576"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BREWER-CUSHMAN",
        "first_name": "HOLLIE",
        "middle_name": "RAE",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-25",
        "last_updated": "2023-09-15",
        "certification_date": "2023-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ME",
            "license": "LC21162",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HOLLIE",
            "last_name": "BREWER",
            "middle_name": "RAE",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Scarborough, ME

Sources for this page

Verify at the official NPI Registry.