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KERRY KIMBALL E.D.D NPI 1770768921


NPI Information

NPI: 1770768921
Provider Name: KERRY KIMBALL, E.D.D
Classification: Psychologist - 103TC0700X
Entity Type: Individual

Specialization: Clinical

Address:
20 MECHANIC ST
GORHAM, ME
ZIP 04038
Phone: (207) 839-2587
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Kerry Kimball, E.D.D is a clinical psychologist in Gorham, 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. Kerry Kimball, E.D.D NPI is 1770768921. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

20 MECHANIC ST
GORHAM, ME
ZIP 04038-560
Phone: (207) 839-2587
Fax: (207) 839-6469

The enumeration date for this NPI number is 1/7/2008 and was last updated on 4/17/2008.


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
1103TC0700XPsychologistClinicalPS574MAINEYes

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 Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1MM0548MEDICARE PINMAINE

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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