Individual provider Active NPI

Bridget Tremblay, PSY.D

  • Marriage & Family Therapist
  • Portland, ME
National Provider Identifier
1407133374
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
4701 Issued in ME
Practice address
500 Forest Ave.
Suite 1a
Portland, ME 04101
Phone
(617) 320-8954
NPI assigned
Nov 7, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 77397 CA
Marriage & Family Therapist 106H00000X 4701 ME Primary

Addresses

Primary practice location

500 Forest Ave.
Suite 1a
Portland, ME 04101

Mailing address

904 Washington Ave
Portland, ME 04103-2733
Phone (617) 320-8954

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
4701MEMDMarriage & Family Therapist
77397CAMDPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist

NPI Registry JSON

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

{
    "created_epoch": "1320624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1407133374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "904 WASHINGTON AVE",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041032733",
            "telephone_number": "617-320-8954"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 FOREST AVE.",
            "address_2": "SUITE 1A",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "04101",
            "telephone_number": "617-320-8954"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TREMBLAY",
        "first_name": "BRIDGET",
        "name_prefix": "Dr.",
        "credential": "PSY.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-11-07",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "77397",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "ME",
            "license": "4701",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Jul 21, 2022; 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.