Ingraham

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

LC10806 Issued in ME

Legal business name

INGRAHAM

Practice address

50 Monument SQ
Portland, ME 04101-4039

Phone

(207) 874-1055

Fax

(207) 775-4034

NPI assigned

Jan 25, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Charles Mitchell, M.D.NPI 1700800703

Title

Medical Director

Phone

(207) 874-1055

Specialties & licenses 1

Addresses

Tax ID family

Ingraham2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Ingraham

  • Adult Mental Health Clinic/Center
  • Portland, ME
  • NPI 1033216106
  NPD tax ID

Locations

Practitioners 1

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.

• Charles Hopkins Mitchell, MD

  • Psychiatry Physician
  • Portland, ME
  • NPI 1700800703
  Authorized official Same address or phone

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

{
    "created_epoch": "1169683200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1356496483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 MONUMENT SQ",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041014039",
            "telephone_number": "207-874-1055",
            "fax_number": "207-775-4034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 MONUMENT SQ",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041014039",
            "telephone_number": "207-874-1055",
            "fax_number": "207-775-4034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INGRAHAM",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-25",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MITCHELL",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "207-874-1055",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "ME",
            "license": "LC10806",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Independent Wound Care PLLC
• Inema Home Health LLC
• Emilie Infinger, M.A. CF-SLP
• Laura Lee Ingalls, LCSW
• Ingraham
• Tristan Ingram
• Veronica Ingrao, LCSW, LICSWLADC, CCS
• Lowell F. Inhorn, M.D.
• Madeline Inlow
• Inspire Health Services LLC

• Community/Behavioral Health Agency in Portland, ME
• Providers in Portland, ME by specialty
• Community/Behavioral Health Agency in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.