Individual provider Active NPI

Bonnie A Cloukey, LCSW

  • Clinical Social Worker
  • Portland, ME
National Provider Identifier
1831655398
Registry record updated Feb 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LC6147 Issued in ME
Practice address
53 Baxter Blvd
Portland, ME 04101-1827
Phone
(603) 883-0005
Fax
(603) 883-0007
NPI assigned
Feb 20, 2019
Last updated
Feb 20, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2019

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 LC6147 ME Primary

Addresses

Primary practice location

53 Baxter Blvd
Portland, ME 04101-1827

Mailing address

1 Main St
Nashua, NH 03064-2716
Phone (603) 689-7978

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050830000587 ME Practitioner - Clinical Social Worker 9234160151 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The Counseling Center of Nashua IncGroup PAC ID 3274523758, 250 clinicians

Practice addresses (Care Compare)

53 Baxter Blvd
Portland, ME 04101-1827
Phone (603) 883-0005

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LC6147MEMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
The Counseling Center of Nashua Inc Clinical CurrentSince May 6, 2019 Accepting new patients

Locations

53 Baxter Blvd
Ste 3
Portland, ME 04101
Phone (207) 613-4115

53 Baxter Blvd
Portland, ME 04101
Phone (207) 245-1648

11 Baxter Blvd
Fl 2
Portland, ME 04101
Phone (207) 775-5671

10 Market St
Ste 205
Scarborough, ME 04074
Phone (207) 503-3583

707 Sable Oaks Dr
Ste 230
South Portland, ME 04106
Phone (207) 387-0801

24 Front St
Exeter, NH 03833
Phone (603) 772-3900

1 Main St
Nashua, NH 03064
Phone (603) 689-7978

Interoperability endpoints

  • Direct secure messaging: ccn.bonniecloukey@140126.advancedmd-direct.com

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1550620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550620800000",
    "number": "1831655398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 MAIN ST",
            "city": "NASHUA",
            "state": "NH",
            "postal_code": "030642716",
            "telephone_number": "603-689-7978",
            "fax_number": "603-883-0007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "53 BAXTER BLVD",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041011827",
            "telephone_number": "603-883-0005",
            "fax_number": "603-883-0007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLOUKEY",
        "first_name": "BONNIE",
        "middle_name": "A",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-20",
        "last_updated": "2019-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ME",
            "license": "LC6147",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, ME

Sources for this page

Verify at the official NPI Registry.