MAINE CHILD PSYCHOLOGY (NPI# 1760744601) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760744601 |
| Entity Type | Organization |
| Organization Name | MAINE CHILD PSYCHOLOGY |
| Practice Address |
2 Elm St Waterville ME 04901-5905 |
| Mailing Address |
322 West Rd Belgrade ME 04917-4111 |
| Practice Telephone | 2072212631 |
| Practice Fax Number | 8666116717 |
| Mailing Telephone | 2072212631 |
| Mailing Fax Number | 8666116717 |
| Enumeration Date | 2012-06-15 |
| Last Update Date | 2012-06-15 |
| Authorized Official Name | DR. GLEN DAVIS (PSYCHOLOGIST) |
| Authorized Official Telephone | 2072212631 |
| Authorized Official Credential | PH.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC2200X |
Psychologist Specialization: Clinical Child & Adolescent |
PS593 | ME | Behavioral Health & Social Service Providers |
| Street Address |
2 ELM ST |
| City | WATERVILLE |
| State | ME |
| Zip Code | 04901-5905 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003034570 | Peter L Burgher | Psychologist | 2 Elm St, Waterville, ME 04901-5905 | 2007-04-23 |
| 1205987690 | Susan A Bouchard | Social Worker | 2 Elm St, Waterville, ME 04901-5905 | 2007-01-15 |
| 1245397314 | Dennis Paul Ratner | Psychologist | 2 Elm St, Waterville, ME 04901-5905 | 2007-01-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093325649 | Orthopedic Physical Therapy | Physical Therapist | Orthopedic Physical Therapy, 234 College Ave, Waterville, ME 04901 | 2020-08-07 |
| 1790328771 | Elizabeth Saucier | Counselor | Discovery House 40 Airport Rd, Waterville, ME 04901 | 2019-10-23 |
| 1780233445 | Amy Marie Tardy | Counselor | 325 Kmd, Building D - Unit 4, 325 Kmd - Building D -- Unit 4, Waterville, ME 04901 | 2019-09-05 |
| 1457905911 | Waterville Audiology PC | Audiologist-Hearing Aid Fitter | 124 Silver Street, Waterville, ME 04901 | 2019-08-01 |
| 1629537048 | Samantha Sobel | Behavioral Analyst | 2 Seton Center Dr, Waterville, ME 04901 | 2019-03-15 |
| 1366916025 | Waterville Pharmacy | Pharmacy | 20 Concourse W, Waterville, ME 04901 | 2019-01-16 |
| 1699243733 | Thomas James Demers | Counselor | Discovery House, 40 Airport Road, Waterville, ME 04901 | 2018-11-07 |
| 1851892442 | Alishia M Austin | Counselor | Discovery House Ctc Waterville 40 Airport Rd, Waterville, ME 04901 | 2018-02-28 |
| 1336671056 | Douglas Joseph Dicola | Family Medicine | Mainegeneral Medical Center, 149 North St, Waterville, ME 04901 | 2017-03-31 |
| 1134660020 | Waterville Medical Supplies | Durable Medical Equipment & Medical Supplies | 325 Waterville Commons Drive, Waterville, ME 04901 | 2017-03-13 |
| Find all providers in zip 04901 | ||||
| Taxonomy Code | 103TC2200X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical Child & Adolescent |
| Definition to come... |
| Notes: [1/1/2007: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770602641 | Shawn R Kalback | Psychologist | 149 North St, Waterville, ME 04901-4974 | 2007-03-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932731593 | Rebecca Stetson Werner | Psychologist | 40 Forest Falls Dr Ste 1, Yarmouth, ME 04096-7005 | 2020-02-11 |
| 1902440704 | Alicia Hoffman | Psychologist | 1577 Congress St Ste 2, Portland, ME 04102-2169 | 2019-11-05 |
| 1346372224 | Laurence Starr | Psychologist | 87 Elm St, Suite 204, Camden, ME 04843-1959 | 2007-03-09 |
| 1366004251 | Lauren Holleb | Psychologist | 1 College Cir, Bangor, ME 04401-2999 | 2019-07-01 |
| 1609388644 | Anna Mayo | Psychologist | 133 Corporate Dr, Bangor, ME 04401 | 2017-10-31 |
| 1356718639 | Jordan Ciel Fearon | Psychologist | 133 Corporate Dr, Emmc, Bangor, ME 04401-4312 | 2015-08-21 |
| 1770875833 | Jennifer Lynn Curran | Psychologist | 133 Corporate Dr, Bangor, ME 04401-4312 | 2011-05-09 |
| 1326358250 | Tim R Rogers | Psychologist | 700 Mount Hope Ave, Suite 680 Evergreen Woods, Bangor, ME 04401-5691 | 2010-10-13 |
| 1275843112 | Andrew R Kahn | Psychologist | 700 Mount Hope Ave, Suite 680 Evergreen Woods, Bangor, ME 04401-5691 | 2010-10-13 |
| 1538348107 | Elizabeth A. Boetsch | Psychologist | 21 Elm St, Third Floor, Camden, ME 04843-1949 | 2007-10-30 |
| Find all providers with the same taxonomy | ||||
| City | WATERVILLE |
| Zip Code | 04901 |
Please comment or provide details below to improve the information on MAINE CHILD PSYCHOLOGY.
| 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.