Susan E Gaudet, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LC14105 Issued in ME

Practice address

84 Gordon Farms Rd
Gorham, ME 04038-2389

Phone

(207) 613-6843

Fax

(207) 419-2732

NPI assigned

Jul 14, 2011

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Susan Farrington Marean Former name

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

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Dragonfly Wellness Studio LLC

  • Clinical Social Worker
  • Gorham, ME
  • NPI 1295263762
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1310601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679356800000",
    "number": "1902194731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "84 GORDON FARMS RD",
            "city": "GORHAM",
            "state": "ME",
            "postal_code": "040382389",
            "telephone_number": "207-613-6843",
            "fax_number": "207-419-2732"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "84 GORDON FARMS RD",
            "city": "GORHAM",
            "state": "ME",
            "postal_code": "040382389",
            "telephone_number": "207-613-6843",
            "fax_number": "207-419-2732"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAUDET",
        "first_name": "SUSAN",
        "middle_name": "E",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-07-14",
        "last_updated": "2023-03-21",
        "certification_date": "2023-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ME",
            "license": "LC14105",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUSAN",
            "last_name": "MAREAN",
            "middle_name": "FARRINGTON",
            "credential": "LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Fredaex LLC (Home Helpers Home Care of Portland, ME)
• Jennifer Friedman, MB CH.B
• Lucas Gagnon
• Logan L Gailitis, ATS
• Michelle Garcia, MD
• Matthew D Gerken, ATC
• Heidi Marie Giasson
• Raul D. Gierbolini, ATS
• Carrie Glenn, DPT
• Golden Group Home Services, LLC

• Clinical Social Worker in Gorham, ME
• Providers in Gorham, 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 Mar 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.