MISS STACEY L PELLETIER (NPI# 1619153665) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619153665 |
| Entity Type | Individual |
| Full Name | MISS STACEY L PELLETIER |
| Credential | LCSW |
| Practice Address |
61 Main St Ste 31 Bangor ME 04401-8300 |
| Mailing Address |
9 Blaisdell Rd Stetson ME 04488-3013 |
| Practice Telephone | 2072995599 |
| Mailing Telephone | 2072925599 |
| Enumeration Date | 2008-01-20 |
| Last Update Date | 2014-04-02 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
LC13699 | ME | Behavioral Health & Social Service Providers |
| Street Address |
61 MAIN ST STE 31 |
| City | BANGOR |
| State | ME |
| Zip Code | 04401-8300 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184222523 | Bj's Wholesale Club Inc. | Eyewear Supplier (Equipment, not the service) | 110 Longview Dr, Bangor, ME 04401 | 2020-10-16 |
| 1033737937 | Daniel John Phulman | Counselor | 202 Exchange Street, Bangor, ME 04401 | 2020-07-08 |
| 1770104358 | Elizabeth Sarah Caruson | Physician Assistant | 417 State Street Webber Medical Building, East St, Ste. 121, Bangor, ME 04401 | 2020-05-05 |
| 1053961300 | Erika Dean | Occupational Therapist | 84 Sylvan Rd., Bangor, ME 04401 | 2019-09-18 |
| 1942853635 | Wildworks Therapy, Pllc | Occupational Therapist | 123 Mt Hope Ave, Bangor, ME 04401 | 2019-07-22 |
| 1255999173 | Jessica Arbisi | Physician Assistant | 1 Northeast Drive, Bangor, ME 04401 | 2019-06-05 |
| 1699232041 | Ehab Khamis Elhefnawi | Anesthesiology | Emmc Anesthesia Professional Service, 489 State Street, Bangor, ME 04401 | 2019-02-21 |
| 1477028884 | Zvorufura Makura | Otolaryngology | 885 Union Street, Ste 145, Bangor, ME 04401 | 2018-10-11 |
| 1255826541 | Lindsey M Fields | Optometrist | 955 Broadway Eye Center Northeast Dba Northeast Eyecare, Bangor, ME 04401 | 2018-06-28 |
| 1992211338 | Debra J Mcintyre | Counselor | 157 Park Street, #5, Bangor, ME 04401 | 2017-12-21 |
| Find all providers in zip 04401 | ||||
| Taxonomy Code | 1041C0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| Specialization | Clinical |
| A social worker who holds a master’s or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master’s supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. |
| Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881231462 | Anne Elizabeth Chamberlain Small | Social Worker | 64 Joans Hill Rd, Bangor, ME 04401-2664 | 2019-12-03 |
| 1144733841 | James Butts | Social Worker | 615 Odlin Rd Ste 3, Bangor, ME 04401-6737 | 2017-11-16 |
| 1316459530 | Julia E Taner | Social Worker | 84 Sylvan Rd, Bangor, ME 04401-4221 | 2017-10-27 |
| 1821446485 | Justin James Umel | Social Worker | 45 Maple St, Bangor, ME 04401-5406 | 2016-05-24 |
| 1174994537 | Jeanette B. Rogers | Social Worker | 43 Columbia Street, Suite 11, Bangor, ME 04401 | 2015-10-12 |
| 1710392956 | Cynthia Michelle Peterson | Social Worker | 15 State St Ste 305, Bangor, ME 04401-5166 | 2014-06-26 |
| 1013343813 | Christine Ann Crittenden Richard | Social Worker | 38 Penn Plz Ste 5, Bangor, ME 04401 | 2013-09-25 |
| 1669720009 | Julie M Sichelstiel | Social Worker | 40 Summer Street 2nd Floor, Bangor, ME 04401-6446 | 2012-08-15 |
| 1952658890 | Cynthia Elaine Sturm | Social Worker | 81 Main St Suite 401, Bangor, ME 04401 | 2012-08-09 |
| 1275802381 | Katherine Anne Dobres-spang | Social Worker | 270 French St, Bangor, ME 04401-5015 | 2011-12-19 |
| Find all providers in BANGOR | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.