Individual provider Active NPI

Nicholas J Rehagen, PH.D.

  • Clinical Psychologist
  • Livermore Falls, ME
National Provider Identifier
1013122175
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
347 Issued in ME
Practice address
2 Pine Ave
Livermore Falls, ME 04254-1330
Phone
(207) 897-5488
Fax
(207) 897-4029
NPI assigned
May 11, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 347 ME Primary

Addresses

Primary practice location

2 Pine Ave
Livermore Falls, ME 04254-1330

Mailing address

49 Androscoggin BLFS
Livermore Falls, ME 04254-4020
Phone (207) 897-5488

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
347MEMDClinical Psychologist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1178841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1013122175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "49 ANDROSCOGGIN BLFS",
            "city": "LIVERMORE FALLS",
            "state": "ME",
            "postal_code": "042544020",
            "telephone_number": "207-897-5488",
            "fax_number": "207-897-4029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 PINE AVE",
            "city": "LIVERMORE FALLS",
            "state": "ME",
            "postal_code": "042541330",
            "telephone_number": "207-897-5488",
            "fax_number": "207-897-4029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REHAGEN",
        "first_name": "NICHOLAS",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "ME",
            "license": "347",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Livermore Falls, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.