Active NPI
Gabrielle Eberly
- Social Worker
- South Portland, ME
National Provider Identifier
1700565983
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- MC22152
- Practice address
- 55 Foden Rd
South Portland, ME 04106-1717 - Phone
- (207) 854-1030
- NPI assigned
- Jul 14, 2023
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Social Worker | 104100000X | MC22152 | ME | Primary |
Addresses
Primary practice location
55 Foden Rd
South Portland, ME 04106-1717
Mailing address
55 Foden Rd
South Portland, ME 04106-1717
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MC22152 | ME | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1689292800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1689292800000",
"number": "1700565983",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "55 FODEN RD",
"city": "SOUTH PORTLAND",
"state": "ME",
"postal_code": "041061717"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "55 FODEN RD",
"city": "SOUTH PORTLAND",
"state": "ME",
"postal_code": "041061717",
"telephone_number": "207-854-1030"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EBERLY",
"first_name": "GABRIELLE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-07-14",
"last_updated": "2023-07-14",
"certification_date": "2023-07-14",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "ME",
"license": "MC22152",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in South Portland, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.