Active NPI
S. Craig Macdonald, LCSW
- Clinical Social Worker
- Bangor, ME
National Provider Identifier
1578771945
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LC4801
- Practice address
- 42 Cedar St
Bangor, ME 04401-6433 - Phone
- (207) 947-0366
- NPI assigned
- May 18, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | LC4801 | ME | Primary |
Addresses
Primary practice location
42 Cedar St
Bangor, ME 04401-6433
Mailing address
PO Box 522
Ellsworth, ME 04605-0522
Phone (207) 664-1994
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 277050099 | Medicaid | ME |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179446400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1298332800000",
"number": "1578771945",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 522",
"city": "ELLSWORTH",
"state": "ME",
"postal_code": "046050522",
"telephone_number": "207-664-1994",
"fax_number": "207-664-1994"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "42 CEDAR ST",
"city": "BANGOR",
"state": "ME",
"postal_code": "044016433",
"telephone_number": "207-947-0366"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MACDONALD",
"first_name": "S.",
"middle_name": "CRAIG",
"name_prefix": "Mr.",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-05-18",
"last_updated": "2011-02-22",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "ME",
"license": "LC4801",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "277050099",
"state": "ME"
}
],
"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 Feb 22, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.