Organization Active NPI

SBSC, Inc.

  • Clinical Psychologist
  • Portland, ME
National Provider Identifier
1255384723
Registry record updated Jun 13, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
SBSC, INC.
Practice address
200 Lancaster St
Portland, ME 04101-2418
Phone
(207) 772-2133
NPI assigned
May 18, 2006
Last updated
Jun 13, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2011

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

Authorized official

Name
Nancy Nager
Title
President/Ceo
Phone
(617) 244-3322

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X
Clinical Psychologist 103TC0700X Primary
Clinical Social Worker 1041C0700X
Psychiatric/Mental Health Registered Nurse 163WP0808X
Psychiatry Physician 2084P0800X

Addresses

Primary practice location

200 Lancaster St
Portland, ME 04101-2418

Mailing address

246 Walnut St
Newton, MA 02460-1689
Phone (617) 244-3322

Other identifiers 2

IdentifierTypeStateIssuer
432125700MedicaidME
425620000MedicaidME

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1147910400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1307923200000",
    "number": "1255384723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "246 WALNUT ST",
            "city": "NEWTON",
            "state": "MA",
            "postal_code": "024601689",
            "telephone_number": "617-244-3322",
            "fax_number": "617-244-1827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 LANCASTER ST",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041012418",
            "telephone_number": "207-772-2133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SBSC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-18",
        "last_updated": "2011-06-13",
        "status": "A",
        "authorized_official_last_name": "NAGER",
        "authorized_official_first_name": "NANCY",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "617-244-3322"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "432125700",
            "state": "ME"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "425620000",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2011; 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.