Bruce Lackie, PH.D.
NPI 1629189824ActiveIndividual· Social Worker, Clinical· Orono, ME
Social Worker, Clinical (PH.D.) in Orono, Maine, licensed in ME, PA and NJ, with an NPI issued in August 2006. Enrolled in Medicare as practitioner - clinical social worker.
Overview
| NPI | 1629189824 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | PH.D. |
| Sole proprietor | Yes |
| NPI issued | Aug 31, 2006 |
| Last updated in NPPES | Jul 8, 2007 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Social Worker, Clinical Primary | 1041C0700X | LC10413 | ME |
| Social Worker, Clinical | 1041C0700X | CW 001208 L | PA |
| Social Worker, Clinical | 1041C0700X | SC-02716 | NJ |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 4, 2026 | No match | — |
| New York OMIG · Nov 4, 2026 | No match | — |
| Ohio Medicaid · Nov 4, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 4, 2026 | No match | — |
| Washington HCA · Nov 4, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Clinical Social Worker (ME) |
|---|
Education and affiliations
| Graduation year | 1971 |
|---|---|
| Medicare specialty | Clinical Social Worker |
| Telehealth | Offers telehealth |
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