Active NPI
Christine R Bergeron, LCSW
- Counselor
- Portland, ME
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- Practice address
- 53 Baxter Blvd Ste 3
Portland, ME 04101-1827 - Phone
- (603) 689-6562
- NPI assigned
- Feb 24, 2020
- Sex
- Female
- Sole proprietor
- No
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 | LC23162 | ME | |
| Counselor | 101Y00000X | Primary |
Addresses
Primary practice location
53 Baxter Blvd Ste 3
Portland, ME 04101-1827
Mailing address
PO Box 568
Kennebunkport, ME 04046-0568
Phone (603) 689-6562
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
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Boston University School of Medicine, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
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
| License | State | Type | Specialty |
|---|---|---|---|
| LC23162 | ME | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Counseling Center of Nashua Inc | Clinical | Current | Accepting new patients |
Locations
53 Baxter Blvd
Ste 3
Portland, ME 04101
Phone (207) 613-4115
11 Baxter Blvd
Fl 2
Portland, ME 04101
Phone (207) 306-9900
53 Baxter Blvd
Portland, ME 04101
Phone (207) 245-1648
1 Main St
Nashua, NH 03064
Phone (603) 689-7978
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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1582502400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1706572800000",
"number": "1982238580",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 568",
"city": "KENNEBUNKPORT",
"state": "ME",
"postal_code": "040460568",
"telephone_number": "603-689-6562"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "53 BAXTER BLVD STE 3",
"city": "PORTLAND",
"state": "ME",
"postal_code": "041011827",
"telephone_number": "603-689-6562"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BERGERON",
"first_name": "CHRISTINE",
"middle_name": "R",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-02-24",
"last_updated": "2024-01-30",
"certification_date": "2024-01-25",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "ME",
"license": "LC23162",
"primary": false
},
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Portland, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2024; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.