Individual provider Active NPI

Andrew F Wisch, PH.D.

  • Psychologist
  • Rockland, ME
National Provider Identifier
1588673156
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PS963 Issued in ME
Practice address
120 Tillson Ave
Suite 201
Rockland, ME 04841-3451
Phone
(207) 594-2900
NPI assigned
Aug 5, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Counseling Psychologist 103TC1900X PS963 ME
Forensic Psychologist 103TF0200X PS963 ME
Psychologist 103T00000X PS963 ME Primary

Addresses

Primary practice location

120 Tillson Ave
Suite 201
Rockland, ME 04841-3451

Mailing address

PO Box 1104
Rockland, ME 04841-1104
Phone (207) 594-2900

Other identifiers 1

IdentifierTypeStateIssuer
047605OtherMEANTHEM BCBS

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)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PS963MEMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1154736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1588673156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1104",
            "city": "ROCKLAND",
            "state": "ME",
            "postal_code": "048411104",
            "telephone_number": "207-594-2900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 TILLSON AVE",
            "address_2": "SUITE 201",
            "city": "ROCKLAND",
            "state": "ME",
            "postal_code": "048413451",
            "telephone_number": "207-594-2900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISCH",
        "first_name": "ANDREW",
        "middle_name": "F",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-05",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "ME",
            "license": "PS963",
            "primary": false
        },
        {
            "code": "103TF0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Forensic",
            "state": "ME",
            "license": "PS963",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "ME",
            "license": "PS963",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "047605",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockland, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.