Active NPI
Suzanne T. Gosselin, LCSW
- School Social Worker
- Hiram, ME
National Provider Identifier
1972559045
On this page
Key facts
NPPES NPI Registry- Primary specialty
- School Social Worker
- License
- LC10742
- Practice address
- 137 S Hiram Rd
Hiram, ME 04041-3636 - Phone
- (207) 625-7134
- Fax
- (207) 625-7186
- NPI assigned
- May 26, 2006
- Last updated
- Mar 31, 2011
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | LC10742 | ME | |
| School Social Worker | 1041S0200X | LC10742 | ME | Primary |
Addresses
Primary practice location
137 S Hiram Rd
Hiram, ME 04041-3636
Mailing address
14 Gosling Road
Shapleigh, ME 04076
Phone (207) 793-3495
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 207970199 | Medicaid | ME |
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LC10742 | ME | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sweetser | Current | Accepting new patients |
Locations
329 Bath Rd
Brunswick, ME 04011
Phone (207) 373-3012
50 Moody St
Saco, ME 04072
Phone (207) 284-5981
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.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Saco, ME
- NPI 1538122445
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148601600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1301529600000",
"number": "1972559045",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14 GOSLING ROAD",
"city": "SHAPLEIGH",
"state": "ME",
"postal_code": "04076",
"telephone_number": "207-793-3495"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "137 S HIRAM RD",
"city": "HIRAM",
"state": "ME",
"postal_code": "040413636",
"telephone_number": "207-625-7134",
"fax_number": "207-625-7186"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOSSELIN",
"first_name": "SUZANNE",
"middle_name": "T.",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-05-26",
"last_updated": "2011-03-31",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "ME",
"license": "LC10742",
"primary": false
},
{
"code": "1041S0200X",
"taxonomy_group": "",
"desc": "Social Worker, School",
"state": "ME",
"license": "LC10742",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "207970199",
"state": "ME"
}
],
"endpoints": [],
"other_names": []
}Other providers in Hiram, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2011; 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.