DR. BRUCE LACKIE (NPI# 1629189824) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629189824 |
| Entity Type | Individual |
| Full Name | DR. BRUCE LACKIE |
| Credential | PH.D. |
| Practice Address |
56 Taylor Rd Orono ME 04473-3205 |
| Practice Telephone | 2078660451 |
| Mailing Telephone | 2078660451 |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1041C0700X |
Social Worker Specialization: Clinical |
SC-02716 | NJ | Behavioral Health & Social Service Providers |
| N | 1041C0700X |
Social Worker Specialization: Clinical |
CW 001208 L | PA | Behavioral Health & Social Service Providers |
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
LC10413 | ME | Behavioral Health & Social Service Providers |
| Street Address |
56 TAYLOR RD |
| City | ORONO |
| State | ME |
| Zip Code | 04473-3205 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225321961 | Orono Med Now | Clinic/Center | 16 Mill Street, Uite 4, Orono, ME 04473 | 2011-05-26 |
| 1134380512 | Renee Light | Social Worker | 6 Stillwater Ave, Orono, ME 04473 | 2008-06-19 |
| 1124048418 | Constance A Poulin | Social Worker | 6 Stillwater Avenue, University Mall, Orono, ME 04473 | 2006-07-20 |
| 1588131247 | Jesse Dale Damron | Occupational Therapy Assistant | 117 Bennoch Rd, Orono, ME 04473 | 2018-10-30 |
| 1356683981 | Penobscot Community Health Center | Clinic/Center | 9 Alumni Dr, Orono, ME 04473 | 2013-03-21 |
| 1093998536 | Cecil A Philpott | Social Worker | 6 Stillwater Avenue, University Mall, Orono, ME 04473 | 2007-12-06 |
| 1770799140 | Rachael Marie Tyler | Social Worker | 6 Stillwater Avenue, University Mall, Orono, ME 04473 | 2007-05-15 |
| 1235354051 | Jessica Ledier Daigle | Social Worker | 6 Stillwater Avenue, University Mall, Orono, ME 04473 | 2007-04-16 |
| 1861557423 | John S Hale Jr. | Psychologist | 69 Main St, Orono, ME 04473 | 2006-12-26 |
| 1750948444 | Lauren Marcella Daigle | Nurse Anesthetist, Certified Registered | 109 Gould Rd, Orono, ME 04473-3038 | 2019-05-29 |
| Find all providers in zip 04473 | ||||
| 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 |
|---|---|---|---|---|
| 1083169361 | Kelly Gagliardo | Social Worker | 41 Boulder Dr Apt 14h, Orono, ME 04473-4681 | 2016-08-16 |
| 1407245632 | Chelsea Rose Mucciarone | Social Worker | 56 Park St Apt 1, Orono, ME 04473-4407 | 2015-01-12 |
| 1801083621 | Summer Sunderland | Social Worker | 97 Forest Ave, Orono, ME 04473-3653 | 2007-09-25 |
| 1598985392 | Laura Durham Anderson | Social Worker | 108 Stillwater Ave, Orono, ME 04473-3410 | 2007-04-26 |
| 1720295207 | Carol Ballou Albright | Social Worker | 90 Park St, Orono, ME 04473-4408 | 2007-05-16 |
| 1518037308 | Nancy Rampe | Social Worker | 69 Main St, Orono, ME 04473-4002 | 2006-11-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619578457 | Julia L Orr | Social Worker | 20 Cheverus Rd, Cape Elizabeth, ME 04107-1204 | 2020-11-06 |
| 1265032957 | Randy Neblett | Social Worker | 104 Main St Unit 1105, Blue Hill, ME 04614-1743 | 2020-10-30 |
| 1871100867 | Purely Spirit Holistic Health, LLC | Social Worker | 226 Stevens Ave Apt 9, Portland, ME 04102-2263 | 2020-09-24 |
| 1831704964 | Cary Rae Millbury | Social Worker | 16 Middle Street, Farmington, ME 04938 | 2020-09-15 |
| 1508471095 | Tighe Blackadar | Social Worker | 46 Evans Rd, Bridgton, ME 04009-3957 | 2020-09-10 |
| 1245845130 | Crescent Psychotherapy | Social Worker | 168 Neal St, Portland, ME 04102-3343 | 2020-09-09 |
| 1295348894 | Alicyn Faythe Romprey | Social Worker | 5 Bragdon Ln, Kennebunk, ME 04043-7262 | 2020-08-25 |
| 1639781354 | Inner Knowing Clinical Therapy LLC | Social Worker | 117 Brown Rd, Durham, ME 04222-5213 | 2020-08-24 |
| 1629687454 | Rebekah Jean Hadiaris | Social Worker | 5 Hadiaris Ln, Saco, ME 04072-1669 | 2020-07-28 |
| 1699383315 | Tracy Flagg | Social Worker | Sacopee Valley Middle School, 137 South Hiram Rd, Hiram, ME 04041 | 2020-07-20 |
| Find all providers with the same taxonomy | ||||
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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.