DR. KENNETH A. BEATTIE (NPI# 1023032869) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023032869 |
| Entity Type | Individual |
| Full Name | DR. KENNETH A. BEATTIE |
| Credential | PH.D. |
| Practice Address |
64 Church St Ellsworth ME 04605-1658 |
| Mailing Address |
94 Mill St Orono ME 04473-4040 |
| Practice Telephone | 2076696011 |
| Practice Fax Number | 2076696011 |
| Mailing Telephone | 2076696011 |
| Mailing Fax Number | 2076696011 |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2007-07-09 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
PS1018 | ME | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ME | 336970000 | 05 |
| Street Address |
64 CHURCH ST |
| City | ELLSWORTH |
| State | ME |
| Zip Code | 04605-1658 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306226675 | Scott Andrew Flagg | Psychologist | 64 Church St, 1a, Ellsworth, ME 04605-1658 | 2015-06-02 |
| 1780024208 | Family Youth Integrated Counseling, Inc. | Community/Behavioral Health | 64 Church St, Ellsworth, ME 04605-1658 | 2013-06-28 |
| 1548597602 | Suzanne Lawrence | Counselor | 64 Church St, Ellsworth, ME 04605-1658 | 2009-11-11 |
| 1568591709 | Marc Mytar | Psychologist | 64 Church St, Ellsworth, ME 04605-1658 | 2007-03-05 |
| 1184784803 | Geoffrey Lascelles Thorpe | Psychologist | 64 Church St, Ellsworth, ME 04605-1658 | 2006-12-11 |
| 1275645939 | Tideside Clinical & Psychological Services | Psychologist | 64 Church St, Tideside, Ellsworth, ME 04605-1658 | 2006-08-31 |
| 1538103726 | Jeffrey Mccarthy | Counselor | 64 Church St, Ellsworth, ME 04605-1658 | 2006-06-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760940464 | Mary Elizabeth Wagstaff | Occupational Therapist | Seaport Village Healthcare, 19 General Moore Way, Ellsworth, ME 04605 | 2019-03-12 |
| 1154784668 | Black Dog Medical Pa | Internal Medicine | 11 Madison Avenue, Lamoine, ME 04605 | 2016-04-01 |
| 1528466687 | Eyecare Now | Point of Service | 248 State St., Ste. 7, Ellsworth, ME 04605 | 2014-12-05 |
| 1104245364 | Elizabeth Arntzen | Massage Therapist | 61 Pine St., Ellsworth, ME 04605 | 2014-04-15 |
| 1992144794 | Kenneth L Senter | Family Medicine | 248 State St., Ellsworth Free Medical Clinic, Ellsworth, ME 04605 | 2013-06-14 |
| 1639465248 | Lynne Marie Betz | Dental Hygienist | 52 Christian Ridge Road, Ellsworth, ME 04605 | 2011-06-22 |
| 1215238431 | Kimberly Ann Burgess | Social Worker | 23 Carriage Way, Ellsworth, ME 04605 | 2010-11-04 |
| 1962713115 | Springy Pond Farm | Voluntary or Charitable | 562 Springy Pond Rd., Otis, ME 04605 | 2010-06-23 |
| 1851629851 | Astor Charlene Gillis | Counselor | 59 Franklin St., Suite B, Ellsworth, ME 04605 | 2009-12-02 |
| 1326372723 | Patricia Brown Orchard | Community Health Worker | 10 Water Street, Suite 124, Ellsworth, ME 04605 | 2009-10-01 |
| Find all providers in zip 04605 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851548242 | Robert Keith Hansen | Psychologist | 710 Bucksport Rd, Ellsworth, ME 04605-2722 | 2008-08-27 |
| 1154469617 | Nancy Ellen Roberts | Psychologist | 5 School St, Ellsworth, ME 04605-1932 | 2007-02-04 |
| 1184784803 | Geoffrey Lascelles Thorpe | Psychologist | 64 Church St, Ellsworth, ME 04605-1658 | 2006-12-11 |
| 1275645939 | Tideside Clinical & Psychological Services | Psychologist | 64 Church St, Tideside, Ellsworth, ME 04605-1658 | 2006-08-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861007387 | Lyle Vintinner | Psychologist | 53 Baxter Blvd Ste 3, Portland, ME 04101-1827 | 2020-09-11 |
| 1720696586 | Sound Mind Psychology LLC | Psychologist | 110 Main St Ste 1201b, Saco, ME 04072-3516 | 2020-07-17 |
| 1134769391 | Lagom Psychology, Pllc | Psychologist | 106 Lafayette St Ste 2b, Yarmouth, ME 04096-6125 | 2020-01-15 |
| 1952942559 | Andrea J Medaris | Psychologist | 153 Park Row Ste 302, Brunswick, ME 04011-2053 | 2019-10-04 |
| 1528539335 | Mark G Kiefner Phd LLC | Psychologist | 225 Commercial St Ste 403, Portland, ME 04101-6603 | 2018-12-06 |
| 1841785680 | Joseph Michael Graziadei | Psychologist | 21 Poolside Ln, Biddeford, ME 04005-9466 | 2018-06-25 |
| 1548770332 | Amanda Seirup | Psychologist | 16 Lincoln St Ste C, Brunswick, ME 04011-1900 | 2017-10-05 |
| 1942743679 | Medoptions of Maine, LLC | Psychologist | 45 Memorial Cir, Augusta, ME 04330-6400 | 2016-11-29 |
| 1578019113 | Lydia Ward-gray, Psyd, LLC | Psychologist | 19 South Street, Suite 4, Portland, ME 04101 | 2016-09-01 |
| 1942652656 | Nancy Slobodnik | Psychologist | 1 Va Ctr # 28, Augusta, ME 04330-6719 | 2016-07-06 |
| 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.