JONATHAN M BORKUM (NPI# 1881709426) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1881709426 |
| Entity Type | Individual |
| Full Name | JONATHAN M BORKUM |
| Credential | PHD |
| Practice Address |
2 Big Sky Ln Waterville ME 04901-4340 |
| Practice Telephone | 2078725800 |
| Practice Fax Number | 2078725888 |
| Mailing Telephone | 2078725800 |
| Mailing Fax Number | 2078725888 |
| Enumeration Date | 2006-08-21 |
| Last Update Date | 2010-06-29 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TH0100X |
Psychologist Specialization: Health Service |
PS991 | ME | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GROUP # MEDICARE | MM9086 | 01 | |
| ME | 295420099 | 05 |
| Street Address |
2 BIG SKY LN |
| City | WATERVILLE |
| State | ME |
| Zip Code | 04901-4340 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134146798 | Health Psych Maine, LLC | Psychologist | 2 Big Sky Ln, Waterville, ME 04901-4340 | 2006-07-17 |
| 1881231553 | 456 Prime LLC | Psychologist | 2 Big Sky Ln, Waterville, ME 04901-4340 | 2019-12-02 |
| 1659631513 | David A Faigin | Psychologist | 2 Big Sky Ln, Waterville, ME 04901-4340 | 2012-05-24 |
| 1801172887 | Carol Ann Caprini Faigin | Psychologist | 2 Big Sky Ln, Waterville, ME 04901-4340 | 2011-10-23 |
| 1790076396 | Marin Rathbun Godsoe | Psychologist | 2 Big Sky Ln, Waterville, ME 04901-4340 | 2011-04-29 |
| 1265647465 | Mark D. Kmen | Social Worker | 2 Big Sky Ln, Waterville, ME 04901-4340 | 2007-05-11 |
| 1023176005 | Christina Marie Fasse | Psychologist | 2 Big Sky Ln, Waterville, ME 04901-4340 | 2006-12-04 |
| 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 | 103TH0100X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Health Service |
| A psychologist, certified/licensed at the independent practice level in his/her state, who is duly trained and experienced in the delivery of direct, preventative, assessment, and therapeutic intervention services to individuals whose growth, adjustment, or functioning is actually impaired or is demonstrably at high risk of impairment (1974). |
| Notes: Source: National Register of Health Service Providers in Psychology website http://www.nationalregister.org/about_NR.html [7/1/2006: modified title, added definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134146798 | Health Psych Maine, LLC | Psychologist | 2 Big Sky Ln, Waterville, ME 04901-4340 | 2006-07-17 |
| 1881231553 | 456 Prime LLC | Psychologist | 2 Big Sky Ln, Waterville, ME 04901-4340 | 2019-12-02 |
| 1891898037 | Laura Holcomb | Psychologist | 30 Chase Ave, Waterville, ME 04901-4624 | 2006-09-06 |
| 1871500090 | Jeff Matranga | Psychologist | 30 Chase Ave, Waterville, ME 04901-4624 | 2006-08-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346899390 | Florence Namuhoranye | Psychologist | 61 Deering St Apt H, Portland, ME 04101-2263 | 2019-09-11 |
| City | WATERVILLE |
| Zip Code | 04901 |
Please comment or provide details below to improve the information on JONATHAN M BORKUM.
| 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.