Individual provider Active NPI

Douglas W Breunig, LCSW

  • Clinical Social Worker
  • Auburn, ME
National Provider Identifier
1780734533
Registry record updated Sep 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LC1162 Issued in ME
Practice address
398 Beech Hill Rd
Auburn, ME 04210-8827
Phone
(207) 784-2039
NPI assigned
Jan 12, 2007
Last updated
Sep 25, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LC1162 ME Primary

Addresses

Primary practice location

398 Beech Hill Rd
Auburn, ME 04210-8827

Mailing address

398 Beech Hill Rd
Auburn, ME 04210-8827
Phone (207) 784-2039

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
LC1162MEMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1168560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1222300800000",
    "number": "1780734533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "398 BEECH HILL RD",
            "city": "AUBURN",
            "state": "ME",
            "postal_code": "042108827",
            "telephone_number": "207-784-2039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "398 BEECH HILL RD",
            "city": "AUBURN",
            "state": "ME",
            "postal_code": "042108827",
            "telephone_number": "207-784-2039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BREUNIG",
        "first_name": "DOUGLAS",
        "middle_name": "W",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-12",
        "last_updated": "2008-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ME",
            "license": "LC1162",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Auburn, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2008; 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.