Individual provider Active NPI

Geoffrey Lascelles Thorpe, PH.D.

  • Clinical Psychologist
  • Ellsworth, ME
National Provider Identifier
1184784803
Registry record updated Nov 10, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PS287 Issued in ME
Practice address
64 Church St
Ellsworth, ME 04605-1658
Phone
(207) 667-2095
NPI assigned
Dec 11, 2006
Last updated
Nov 10, 2012By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 10, 2012

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 PS287 ME Primary

Addresses

Primary practice location

64 Church St
Ellsworth, ME 04605-1658

Mailing address

PO Box 1200
Holden, ME 04429-1200
Phone (207) 843-5262

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050627000109 ME Practitioner - Clinical Psychologist 6901841360 Practice locations: Ellsworth, ME

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1973
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

64 Church St
Suite 2
Ellsworth, ME 04605-1607
Phone (207) 667-2095

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PS287MEMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Tideside Clinical & Psychological Services 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352505600000",
    "number": "1184784803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1200",
            "city": "HOLDEN",
            "state": "ME",
            "postal_code": "044291200",
            "telephone_number": "207-843-5262",
            "fax_number": "207-843-6754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "64 CHURCH ST",
            "city": "ELLSWORTH",
            "state": "ME",
            "postal_code": "046051658",
            "telephone_number": "207-667-2095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THORPE",
        "first_name": "GEOFFREY",
        "middle_name": "LASCELLES",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-11",
        "last_updated": "2012-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "ME",
            "license": "PS287",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ellsworth, ME

Sources for this page

Verify at the official NPI Registry.