Kerry Drach, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PS623 Issued in ME

Practice address

17 Bishop St
Portland, ME 04103-2659

Phone

(207) 871-1235

Fax

(207) 879-6161

NPI assigned

Nov 17, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Spurwink Services Incorporated

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Portland, ME
  • NPI 1316945090
  NPD (past)

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

{
    "created_epoch": "1163721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1063586683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "899 RIVERSIDE ST",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041031070",
            "telephone_number": "207-871-1200",
            "fax_number": "207-871-1232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 BISHOP ST",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041032659",
            "telephone_number": "207-871-1235",
            "fax_number": "207-879-6161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DRACH",
        "first_name": "KERRY",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-17",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "ME",
            "license": "PS623",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "RB8",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joel Steven Doyon, DDS
• Stacey L Doyon, O.T.
• Dr James Kuper LLC
• Dr. Katherine M. Casale, LLC
• Christine J. Drabek, LADC, M.S., CCS
• Hossan Gabriel Bersamina Draculan
• Sydney Dranow, LCPC-C
• Douglas Dransfield, M.D.
• Cheryl R. Drda, ARNP
• Dream Logic LLC

• Clinical Psychologist in Portland, ME
• Providers in Portland, ME by specialty
• Clinical Psychologist in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.