NPIMap

Organization Active NPI

Deborah J Devine PSYD, PA

  • Psychologist
  • Gorham, ME
National Provider Identifier
1114194081
Registry record updated Sep 12, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Legal business name
DEBORAH J DEVINE PSYD, PA
Practice address
20 Mechanic St
Gorham, ME 04038-1560
Phone
(207) 839-2450
Fax
(207) 839-6469
NPI assigned
May 10, 2008
Last updated
Sep 12, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2008

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

Authorized official

Name
Deborah J Devine, PSYDNPI 1780657197
Title
Owner
Phone
(207) 839-2450

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X NU Primary

Addresses

Primary practice location

20 Mechanic St
Gorham, ME 04038-1560

Mailing address

20 Mechanic St
Gorham, ME 04038-1560
Phone (207) 839-2450

Other identifiers 3

IdentifierTypeStateIssuer
025624OtherMEANTHEM
ME0237OtherMEMEDICARE
251920000MedicaidME

National Provider Directory

National Provider Directory

Locations

20 Mechanic St
Gorham, ME 04038
Phone (207) 839-2450

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1210377600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1221177600000",
    "number": "1114194081",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 MECHANIC ST",
            "city": "GORHAM",
            "state": "ME",
            "postal_code": "040381560",
            "telephone_number": "207-839-2450",
            "fax_number": "207-839-6469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 MECHANIC ST",
            "city": "GORHAM",
            "state": "ME",
            "postal_code": "040381560",
            "telephone_number": "207-839-2450",
            "fax_number": "207-839-6469"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEBORAH J DEVINE PSYD, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-10",
        "last_updated": "2008-09-12",
        "status": "A",
        "authorized_official_last_name": "DEVINE",
        "authorized_official_first_name": "DEBORAH",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "207-839-2450",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "025624",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "ME0237",
            "state": "ME"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "251920000",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gorham, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2008; 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.