Christopher McInnis, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LC11536 Issued in ME

Practice address

1012 Union St
Penobscot Community Health Center
Bangor, ME 04401-3060

Phone

(207) 404-8100

NPI assigned

Oct 3, 2006

Last updated

Apr 19, 2016By the provider in NPPES

Sex

Male

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 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Pine Tree Urgent Care LLC

  • Urgent Care Clinic/Center
  • Bangor, ME
  • NPI 1679450969
  NPD

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461024000000",
    "number": "1730273897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1599",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044021599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1012 UNION ST",
            "address_2": "PENOBSCOT COMMUNITY HEALTH CENTER",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044013060",
            "telephone_number": "207-404-8100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCINNIS",
        "first_name": "CHRISTOPHER",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2016-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ME",
            "license": "LC11536",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "161040200",
            "state": "ME"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "434137099",
            "state": "ME"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "161040203",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michael C McGoldrick, MD
• Frank R. McGrady, PHARMD
• Sean McGrath, M.D.
• Amy Lynn McGuire, RDH
• Daniel Thompson McGuire, MD
• Melinda S McInnis, FNPC
• Debra J McIntyre
• Jamie McKay, LADC, CCS, LSW
• Matthew S. McKay, MD
• Stephen E McKay, PHD

• 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 Apr 19, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.