Active NPI
Miriam Wolfenstein, PH.D.
- Clinical Psychologist
- Kennebunk, ME
National Provider Identifier
1073884151
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PS1416
- Practice address
- 62 Portland Rd 42
Kennebunk, ME 04043-6650 - Phone
- (207) 251-7147
- Fax
- (888) 858-8495
- NPI assigned
- Jan 20, 2012
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PS1416 | ME | Primary |
Addresses
Primary practice location
62 Portland Rd 42
Kennebunk, ME 04043-6650
Mailing address
50 Brown St
Kennebunk, ME 04043-7242
Phone (207) 467-3115
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in ME
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20151020001530 | ME | Practitioner - Clinical Psychologist | 2860701547 | Practice locations: Kennebunk, ME |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 2001
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
62 Portland Rd
Suite 42
Kennebunk, ME 04043-6650
Phone (207) 251-7147
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PS1416 | ME | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1327017600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1557360000000",
"number": "1073884151",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "50 BROWN ST",
"city": "KENNEBUNK",
"state": "ME",
"postal_code": "040437242",
"telephone_number": "207-467-3115"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "62 PORTLAND RD 42",
"city": "KENNEBUNK",
"state": "ME",
"postal_code": "040436650",
"telephone_number": "207-251-7147",
"fax_number": "888-858-8495"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WOLFENSTEIN",
"first_name": "MIRIAM",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-01-20",
"last_updated": "2019-05-09",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "ME",
"license": "PS1416",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kennebunk, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.