Lynn A Quackenbush, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LC7004 Issued in ME

Practice address

268 Stillwater Ave
Acadia Hospital Corp.
Bangor, ME 04401-3945

Phone

(207) 973-6100

Fax

(207) 973-6109

NPI assigned

Sep 22, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Apr 1, 2024 through Apr 1, 2028

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Acadia Healthcare, Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Bangor, ME
  • NPI 1568477297
  NPD (past)
• Mid-Coast Mental Health Center

  • Community/Behavioral Health Agency
  • Rockland, ME
  • NPI 1376642066
  NPD (past)

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

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534118400000",
    "number": "1710087663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12301 S MAIN ST",
            "address_2": "THE MENNINGER CLINIC",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770356207",
            "telephone_number": "713-275-5000",
            "fax_number": "207-973-6109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "268 STILLWATER AVE",
            "address_2": "ACADIA HOSPITAL CORP.",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044013945",
            "telephone_number": "207-973-6100",
            "fax_number": "207-973-6109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUACKENBUSH",
        "first_name": "LYNN",
        "middle_name": "A",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-22",
        "last_updated": "2018-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ME",
            "license": "LC7004",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104000000",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bethany Purinton
• Una Leanna Purvis, RDH, IPDH
• Paul Franklin Pusey
• John I Pyne, MD
• Amina S Qazi, DO, PHARMD
• Quality Care Group Homes
• Quality Daily Home Services LLC
• Amanda Gail Querry, D.O.
• Ellen M Query, NP
• Quest Diagnostics LLC

• Clinical Social Worker in Bangor, ME
• Providers in Bangor, ME by specialty
• Clinical Social Worker in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.