Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mary D Moore, LCSW

Individual provider Addiction (Substance Use Disorder) Counselor · NPI 1134350234

Mary D Moore, LCSW is a Clinical Social Worker in Bangor, Maine. Qualified in 2005, 21 years ago. Practices with Penobscot Community Health Center, a 132-clinician group and accepts Medicare assignment. Licensed in Maine.

Years since qualifying
21
Licensed in
ME
In the registry since
2009
Specialties on file
2
What do these letters mean?
LCSW — Licensed Clinical Social Worker
A social worker licensed to diagnose and treat mental health conditions independently.

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Practice location Address checks out

1012 Union St
Bangor, ME 04401-3060
Phone: (207) 945-5247
Fax: (207) 990-1248
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Mental Health Counselor (primary) Taxonomy 101YM0800X · Licence LC12013 (ME)
Addiction (Substance Use Disorder) Counselor Taxonomy 101YA0400X · Licence LC1351 (ME)

Record details

NPI number1134350234
Entity typeIndividual (Type 1)
GenderFemale
Credentials LCSW
Sole proprietorNo
NPI enumeratedAugust 6, 2009
Last updated in NPPESMay 5, 2021
Certification dateMay 5, 2021

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2005 (21 years in practice)
Group practice Penobscot Community Health Center — 132 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations6 on file with Medicare

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