Jean Fahey, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PS1376 Issued in ME

Practice address

27 Gorham Rd
Suite 13
Scarborough, ME 04074

Phone

(781) 862-3219

NPI assigned

Dec 15, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

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

Specialty

Clinical Psychologist

Education

Other, 1992

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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

• Maine Medical Partners

  dba Maine Medical Partners Endocrinology & Diabetes Center

  • Endocrinology, Diabetes & Metabolism Physician
  • Scarborough, ME
  • NPI 1447354899
  Medicare reassignment NPD
• Deer Oaks Mental Health Associates PC

  • Clinical Psychologist
  • Las Cruces, NM
  • NPI 1134175763

  ME

  Medicare reassignment NPD
• Maine Medical Partners

  • Surgery Physician
  • Scarborough, ME
  • NPI 1346687167
  NPD

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

{
    "created_epoch": "1166140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573084800000",
    "number": "1477615441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27 GORHAM RD",
            "address_2": "SUITE 13",
            "city": "SCARBOROUGH",
            "state": "ME",
            "postal_code": "04074",
            "telephone_number": "781-862-3219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27 GORHAM RD",
            "address_2": "SUITE 13",
            "city": "SCARBOROUGH",
            "state": "ME",
            "postal_code": "04074",
            "telephone_number": "781-862-3219"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAHEY",
        "first_name": "JEAN",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-15",
        "last_updated": "2019-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "ME",
            "license": "PS1376",
            "primary": true
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "ME",
            "license": "PS1376",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "6698",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Employment Connections Maine LLC
• Judith L Entwistle, LCSW
• Jeryl Erickson, M.S.
• Sean Michael Etheridge, PA-C
• Brenda Belarger Eugley, PTA
• Mary C. Fahrenbach, M.D.
• Kelly Falone
• Family Hope
• Abtin Farahmand, MD
• Benedict J Farino, MD

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.