Individual provider Active NPI

Lacey Andrews Gale, LCSW

  • Clinical Social Worker
  • Bath, ME
National Provider Identifier
1659825818
Registry record updated Oct 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LC17329 Issued in ME
Practice address
72 Front St Ste 1
Bath, ME 04530
Phone
(207) 522-5335
NPI assigned
Aug 5, 2016
Last updated
Oct 19, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 19, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X MC16160 ME
Clinical Social Worker 1041C0700X LC17329 ME Primary

Addresses

Primary practice location

72 Front St Ste 1
Bath, ME 04530

Mailing address

72 Front St Ste 1
Bath, ME 04530-2657
Phone (207) 522-5335

Other practice location 1

72 Front St Ste 1
Bath, ME 04530
Phone (207) 522-5335

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
I20200310001383 ME Practitioner - Clinical Social Worker 2668800400 Practice locations: Brunswick, ME

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

9 Everett St
Brunswick, ME 04011-2403
Phone (207) 522-5335

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MC16160MEMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1470355200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539907200000",
    "number": "1659825818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "72 FRONT ST STE 1",
            "city": "BATH",
            "state": "ME",
            "postal_code": "045302657",
            "telephone_number": "207-522-5335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "72 FRONT ST STE 1",
            "city": "BATH",
            "state": "ME",
            "postal_code": "04530",
            "telephone_number": "207-522-5335"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "72 Front St Ste 1",
            "address_purpose": "LOCATION",
            "city": "Bath",
            "state": "ME",
            "postal_code": "04530",
            "country_code": "US",
            "telephone_number": "207-522-5335",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GALE",
        "first_name": "LACEY",
        "middle_name": "ANDREWS",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-08-05",
        "last_updated": "2018-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ME",
            "license": "MC16160",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ME",
            "license": "LC17329",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bath, ME

Sources for this page

Verify at the official NPI Registry.