Active NPI
Teresa Pawletkoo
- School Psychologist
- Portland, ME
National Provider Identifier
1467151217
On this page
Key facts
NPPES NPI Registry- Primary specialty
- School Psychologist
- License
- PS1303
- Practice address
- 110 Starbird Rd # 7
Portland, ME 04102-1758 - Phone
- (603) 396-1645
- NPI assigned
- Mar 1, 2023
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| School Psychologist | 103TS0200X | PS1303 | ME | Primary |
Addresses
Primary practice location
110 Starbird Rd # 7
Portland, ME 04102-1758
Mailing address
110 Starbird Rd # 7
Portland, ME 04102-1758
Phone (603) 396-1645
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
| License | State | Type | Specialty |
|---|---|---|---|
| PS1303 | ME | MD | School Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1677628800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1677628800000",
"number": "1467151217",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "110 STARBIRD RD # 7",
"city": "PORTLAND",
"state": "ME",
"postal_code": "041021758",
"telephone_number": "603-396-1645"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "110 STARBIRD RD # 7",
"city": "PORTLAND",
"state": "ME",
"postal_code": "041021758",
"telephone_number": "603-396-1645"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PAWLETKOO",
"first_name": "TERESA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-03-01",
"last_updated": "2023-03-01",
"certification_date": "2023-03-01",
"status": "A"
},
"taxonomies": [
{
"code": "103TS0200X",
"taxonomy_group": "",
"desc": "Psychologist, School",
"state": "ME",
"license": "PS1303",
"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 Mar 1, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.