Dragonfly Psychological Services LLC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

Legal business name

DRAGONFLY PSYCHOLOGICAL SERVICES LLC

Practice address

9 Bowdoin Mill Is
Topsham, ME 04086-1263

Phone

(207) 358-9607

NPI assigned

Nov 23, 2020

Last updated

Sep 21, 2022By 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

Dr. Andrea Medaris, PSYDNPI 1952942559

Title

Director

Phone

(207) 358-9607

Specialties & licenses 1

Addresses

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.

• Andrea J Medaris, PSY.D

  • Clinical Psychologist
  • Brunswick, ME
  • NPI 1952942559
  NPD Authorized official

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

{
    "created_epoch": "1606089600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1663718400000",
    "number": "1437753290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 BOWDOIN MILL IS",
            "city": "TOPSHAM",
            "state": "ME",
            "postal_code": "040861263",
            "telephone_number": "207-358-9607",
            "fax_number": "352-206-7207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 BOWDOIN MILL IS",
            "city": "TOPSHAM",
            "state": "ME",
            "postal_code": "040861263",
            "telephone_number": "207-358-9607"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DRAGONFLY PSYCHOLOGICAL SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-23",
        "last_updated": "2022-09-21",
        "certification_date": "2022-09-21",
        "status": "A",
        "authorized_official_last_name": "MEDARIS",
        "authorized_official_first_name": "ANDREA",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "207-358-9607",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Psychologist in Topsham, ME
• Providers in Topsham, ME by specialty
• Clinical Psychologist in Maine

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