Individual provider Active NPI

Cameron Bergeron, LICSW

  • Clinical Social Worker
  • Nashua, NH
National Provider Identifier
1700295458
Registry record updated Aug 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
45 High St
Nashua, NH 03060-3312
Phone
(603) 816-3133
NPI assigned
Aug 7, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X
Clinical Social Worker 1041C0700X Primary

Addresses

Primary practice location

45 High St
Nashua, NH 03060-3312

Mailing address

77 Northeastern Blvd
Nashua, NH 03062-3128
Phone (603) 882-3616

Other names 1

  • Cameron Holmes Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH
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
I20210216000177 NH Practitioner - Clinical Social Worker 6406261999 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2017
Medicare assignment
May accept Medicare assignment
Group practices
Harbor Homes, Inc.Group PAC ID 4587714779, 14 clinicians

Practice addresses (Care Compare)

45 High St
Nashua, NH 03060-3312
Phone (603) 821-7788

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2364NHMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Harbor Homes, Inc. Clinical CurrentSince Nov 3, 2020 Accepting new patients
Harbor Homes, Inc CurrentSince Nov 3, 2020 Accepting new patients
Harbor Homes, Inc. Clinical Past Accepting new patients

Locations

77 Northeastern Blvd
Nashua, NH 03062
Phone (603) 882-3616

615 Amherst St
Ste 1
Nashua, NH 03063
Phone (603) 881-4848

77 Northeastern Blvd
Ste C
Nashua, NH 03062

45 High St
Nashua, NH 03060
Phone (603) 821-7788

615 Amherst St
Nashua, NH 03063
Phone (603) 821-7788

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1407369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661385600000",
    "number": "1700295458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "77 NORTHEASTERN BLVD",
            "city": "NASHUA",
            "state": "NH",
            "postal_code": "030623128",
            "telephone_number": "603-882-3616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 HIGH ST",
            "city": "NASHUA",
            "state": "NH",
            "postal_code": "030603312",
            "telephone_number": "603-816-3133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERGERON",
        "first_name": "CAMERON",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-07",
        "last_updated": "2022-08-25",
        "certification_date": "2022-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CAMERON",
            "last_name": "HOLMES",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Nashua, NH

Sources for this page

Verify at the official NPI Registry.