PEDS CLINIC INC NPI 1467689786

NPI Information

  • NPI: 1467689786
  • Provider Name: PEDS CLINIC, INC
  • Classification: Specialist - 174400000X
  • Entity Type: Organization
  • Address: 3 WEBHANNET PL
    SUITE 2
    KENNEBUNK, ME
    ZIP 04043
  • Phone: (207) 467-8215

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NPI Details

PEDS CLINIC, INC is a specialist in Kennebunk, ME. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. PEDS CLINIC, INC NPI is 1467689786. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

3 WEBHANNET PL
SUITE 2
KENNEBUNK, ME
ZIP 04043-273
Phone: (207) 467-8215

The provider's authorized official is Mari Jo Allen .
The authorized official title is Executive Director and has the following contact phone number (207) 467-8215.

The enumeration date for this NPI number is 6/12/2009 and was last updated on 6/12/2009.

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
1101Y00000XCounselor572387MAINENo
2101YA0400XCounselorAddiction (Substance Use Disorder)572387MAINENo
3101YM0800XCounselorMental Health572387MAINENo
4103G00000XClinical Neuropsychologist572387MAINENo
5103TA0700XPsychologistAdult Development & Aging572387MAINENo
6103TB0200XPsychologistCognitive & Behavioral572387MAINENo
7103TC2200XPsychologistClinical Child & Adolescent572387MAINENo
81041C0700XSocial WorkerClinical572387MAINENo
9106H00000XMarriage & Family Therapist572387MAINENo
102080A0000XPediatricsAdolescent Medicine572387MAINENo
11225X00000XOccupational Therapist572387MAINENo
12363LP0200XNurse PractitionerPediatrics572387MAINENo
13174400000XSpecialistYes

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: 11/21/2025

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