Active NPI
Carl Leslie Goodwin-Moore, LMSW-CC
- Clinical Social Worker
- Belfast, ME
National Provider Identifier
1811218571
On this page
OIG exclusion record
The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:
- Section 1128b(4) exclusion effective Jul 19, 2012.
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- MC12409
- Practice address
- 9 Field St
Suite 434
Belfast, ME 04915-6661 - Phone
- (207) 338-8960
- Fax
- (207) 338-8962
- NPI assigned
- Jun 17, 2010
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | MC12409 | ME | Primary |
Addresses
Primary practice location
9 Field St
Suite 434
Belfast, ME 04915-6661
Mailing address
PO Box 570
Lincolnville, ME 04849-0570
Phone (207) 323-5143
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
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MC12409 | ME | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1276732800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1276732800000",
"number": "1811218571",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 570",
"city": "LINCOLNVILLE",
"state": "ME",
"postal_code": "048490570",
"telephone_number": "207-323-5143"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9 FIELD ST",
"address_2": "SUITE 434",
"city": "BELFAST",
"state": "ME",
"postal_code": "049156661",
"telephone_number": "207-338-8960",
"fax_number": "207-338-8962"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOODWIN-MOORE",
"first_name": "CARL",
"middle_name": "LESLIE",
"credential": "LMSW-CC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-06-17",
"last_updated": "2010-06-17",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "ME",
"license": "MC12409",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Belfast, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.