Emmanuel Norman Gideon Sr.

Primary specialty

Cognitive & Behavioral PsychologistTaxonomy code 103TB0200X

License

9957298 Issued in ME

Practice address

15 Wainwright Cir E
South Portland, ME 04106-2516

Phone

(207) 671-5054

NPI assigned

Apr 6, 2022

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1649203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649203200000",
    "number": "1508507047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 WAINWRIGHT CIR E",
            "city": "SOUTH PORTLAND",
            "state": "ME",
            "postal_code": "041062516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 WAINWRIGHT CIR E",
            "city": "SOUTH PORTLAND",
            "state": "ME",
            "postal_code": "041062516",
            "telephone_number": "207-671-5054"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIDEON",
        "first_name": "EMMANUEL",
        "middle_name": "NORMAN",
        "name_suffix": "Sr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-04-06",
        "last_updated": "2022-04-06",
        "certification_date": "2022-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TB0200X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "ME",
            "license": "9957298",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Genevieve Spears LLC
• Oren Gersten, MD
• Ethan Gervais, PHARMD
• Roslyn Gerwin, D.O.
• Joe Ghorayeb
• Alex James Gilbert, LMSW - CC
• Sarah Gilbert, RDN, LD
• John William Gilboy, MD
• Leah A Giles, CADC
• Heather M Gillespie, MD

• Cognitive & Behavioral Psychologist in South Portland, ME
• Providers in South Portland, ME by specialty
• Cognitive & Behavioral Psychologist in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 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.