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TIDESIDE CLINICAL & PSYCHOLOGICAL SERVICES NPI 1275645939


NPI Information

NPI: 1275645939
Provider Name: TIDESIDE CLINICAL & PSYCHOLOGICAL SERVICES

Other Name: TIDESIDE

Classification: Psychologist - 103TC0700X
Entity Type: Organization

Specialization: Clinical

Address:
64 CHURCH ST
TIDESIDE
ELLSWORTH, ME
ZIP 04605
Phone: (207) 669-6011
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TIDESIDE CLINICAL & PSYCHOLOGICAL SERVICES is a clinical psychologist in Ellsworth, ME. The provider is a psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems. TIDESIDE CLINICAL & PSYCHOLOGICAL SERVICES NPI is 1275645939. The provider is registered as an organization entity type and is a single specialty group.
The provider Other Name Is Tideside.

The provider's business location address is:

64 CHURCH ST
TIDESIDE
ELLSWORTH, ME
ZIP 04605-658
Phone: (207) 669-6011
Fax: (207) 669-6011

The provider's authorized official is Kenneth A. Beattie .
The authorized official title is Sole Owner and has the following contact phone number (207) 669-6011.

The enumeration date for this NPI number is 8/31/2006 and was last updated on 8/22/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1103TC0700XPsychologistClinicalPS1018MAINEYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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