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NEUROPSYCHOLOGY SERVICE PA NPI 1811100068


NPI Information

NPI: 1811100068
Provider Name: NEUROPSYCHOLOGY SERVICE PA
Classification: Psychologist - 103TC0700X
Entity Type: Organization

Specialization: Clinical

Address:
277 STATE STREET
SUITE 2A
BANGOR, ME
ZIP 04401
Phone: (207) 990-2580
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NEUROPSYCHOLOGY SERVICE PA is a clinical psychologist in Bangor, 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. NEUROPSYCHOLOGY SERVICE PA NPI is 1811100068. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

277 STATE STREET
SUITE 2A
BANGOR, ME
ZIP 04401-440
Phone: (207) 990-2580
Fax: (207) 990-1930

The provider's authorized official is Royal G Grueneich .
The authorized official title is President and has the following contact phone number (207) 990-2580.

The enumeration date for this NPI number is 5/7/2007 and was last updated on 12/2/2010.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1103TC0700XPsychologistClinicalYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1NEMM7057MEDICARE ID-TYPE UNSPECIFIED
2P0724OTHERANTHEM
35418635OTHERAETNA

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: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.