Individual provider Active NPI

Stacy Whitcomb-Smith, PHD

  • Clinical Psychologist
  • Augusta, ME
National Provider Identifier
1396769642
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PS1158 Issued in ME
Practice address
66 Stone St
Augusta, ME 04330-5227
Phone
(207) 626-3455
Fax
(207) 626-3612
NPI assigned
Jul 27, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 PS1158 ME Primary

Addresses

Primary practice location

66 Stone St
Augusta, ME 04330-5227

Mailing address

66 Stone St
Augusta, ME 04330-5227
Phone (207) 626-3455

Other names 1

  • Stacy Renae Whitcomb Former name

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
I20050808001262 ME Practitioner - Clinical Psychologist 3375572589 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Health Psych Maine LLCGroup PAC ID 9739513219, 9 clinicians

Practice addresses (Care Compare)

2 Big Sky LN
Waterville, ME 04901-4340
Phone (207) 872-5800

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Health Psych Maine LLC CurrentSince Oct 17, 2019 Accepting new patients
Kennebec Valley Mental Health Center PastSince Nov 6, 2000 Accepting new patients

Locations

2 Big Sky Ln
Waterville, ME 04901
Phone (207) 872-5800

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1396769642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "66 STONE ST",
            "city": "AUGUSTA",
            "state": "ME",
            "postal_code": "043305227",
            "telephone_number": "207-626-3455",
            "fax_number": "207-626-3612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "66 STONE ST",
            "city": "AUGUSTA",
            "state": "ME",
            "postal_code": "043305227",
            "telephone_number": "207-626-3455",
            "fax_number": "207-626-3612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITCOMB-SMITH",
        "first_name": "STACY",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "ME",
            "license": "PS1158",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STACY",
            "last_name": "WHITCOMB",
            "middle_name": "RENAE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Augusta, ME

Sources for this page

Verify at the official NPI Registry.