Organization Active NPI

Peace Behavioral Health LLC

  • Child & Adolescent Psychiatry Physician
  • Saco, ME
National Provider Identifier
1366138984
Registry record updated Oct 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
Legal business name
PEACE BEHAVIORAL HEALTH LLC
Practice address
110 Main St Ste 1300D
Saco, ME 04072-3505
Phone
(207) 200-4789
Fax
(786) 685-2120
NPI assigned
Apr 17, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2024

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

Authorized official

Name
Dr. Nicolas D Sikaczowski, DONPI 1083147920
Title
Owner
Phone
(305) 600-3182

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X
Child & Adolescent Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0804X Primary

Addresses

Primary practice location

110 Main St Ste 1300D
Saco, ME 04072-3505

Mailing address

110 Main St Ste 1300D
Saco, ME 04072-3505
Phone (207) 200-4789

National Provider Directory

National Provider Directory

Locations

3081 Salzedo St
Ste 202U
Coral Gables, FL 33134
Phone (786) 503-4499

110 Main St
Ste 1300D
Saco, ME 04072
Phone (207) 200-4789

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1681689600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729468800000",
    "number": "1366138984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 MAIN ST STE 1300D",
            "city": "SACO",
            "state": "ME",
            "postal_code": "040723505",
            "telephone_number": "207-200-4789",
            "fax_number": "786-685-2120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 MAIN ST STE 1300D",
            "city": "SACO",
            "state": "ME",
            "postal_code": "040723505",
            "telephone_number": "207-200-4789",
            "fax_number": "786-685-2120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEACE BEHAVIORAL HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-04-17",
        "last_updated": "2024-10-21",
        "certification_date": "2024-10-21",
        "status": "A",
        "authorized_official_last_name": "SIKACZOWSKI",
        "authorized_official_first_name": "NICOLAS",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "305-600-3182",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saco, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2024; 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.