Individual provider Active NPI

Monika Moroz-Bourque, LCSW

  • Clinical Social Worker
  • Saco, ME
National Provider Identifier
1902919368
Registry record updated Apr 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LC4309 Issued in ME
Practice address
333 Lincoln St Ste 217
Saco, ME 04072-3113
Phone
(207) 632-5152
NPI assigned
Aug 17, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 20, 2020

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 LC4309 ME Primary

Addresses

Primary practice location

333 Lincoln St Ste 217
Saco, ME 04072-3113

Mailing address

47 Grandview Dr
Westbrook, ME 04092-3682
Phone (207) 632-5152

Other identifiers 1

IdentifierTypeStateIssuer
266390099MedicaidME

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
I20050908000177 ME Practitioner - Clinical Social Worker 6800828120 Practice locations: Saco, ME

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

333 Lincoln St
Suite 217
Saco, ME 04072-3113
Phone (207) 632-5152

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Debbie Papps LCSW LLC Clinical CurrentSince Apr 26, 2020 Accepting new patients
Maine Behavioral Healthcare Past Accepting new patients

Locations

333 Lincoln St
Ste 217
Saco, ME 04072
Phone (207) 632-5152

333 Lincoln St
Saco, ME 04072
Phone (207) 282-5188

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1155772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587340800000",
    "number": "1902919368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "47 GRANDVIEW DR",
            "city": "WESTBROOK",
            "state": "ME",
            "postal_code": "040923682",
            "telephone_number": "207-632-5152"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 LINCOLN ST STE 217",
            "city": "SACO",
            "state": "ME",
            "postal_code": "040723113",
            "telephone_number": "207-632-5152"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOROZ-BOURQUE",
        "first_name": "MONIKA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-17",
        "last_updated": "2020-04-20",
        "certification_date": "2020-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ME",
            "license": "LC4309",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "266390099",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saco, ME

Sources for this page

Verify at the official NPI Registry.