Active NPI
Farhana Shah, PHD
- Clinical Psychologist
- Freeport, ME
National Provider Identifier
1083706139
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- P5954
- Practice address
- 174 S Freeport Rd
2E
Freeport, ME 04032 - Phone
- (207) 865-9225
- Fax
- (207) 865-9241
- NPI assigned
- Sep 28, 2006
- Sex
- Female
- Sole proprietor
- No
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 | P5954 | ME | Primary |
Addresses
Primary practice location
174 S Freeport Rd
2E
Freeport, ME 04032
Mailing address
174 S Freeport Rd 2E
Freeport, ME 04032
Phone (207) 865-9225
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 038264 | Other | ME | ANTHEM |
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)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| P5954 | ME | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sonnet Psychological, LLC | Clinical | Past | Accepting new patients |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159401600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1083706139",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "174 S FREEPORT RD 2E",
"city": "FREEPORT",
"state": "ME",
"postal_code": "04032",
"telephone_number": "207-865-9225",
"fax_number": "207-865-9241"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "174 S FREEPORT RD",
"address_2": "2E",
"city": "FREEPORT",
"state": "ME",
"postal_code": "04032",
"telephone_number": "207-865-9225",
"fax_number": "207-865-9241"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHAH",
"first_name": "FARHANA",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-09-28",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "ME",
"license": "P5954",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM",
"identifier": "038264",
"state": "ME"
}
],
"endpoints": [],
"other_names": []
}Other providers in Freeport, 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.