Bonnie Creech, PH.D.

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

PS1143 Issued in ME

Practice address

905 Union St Ste 9
Bangor, ME 04401-3039

Phone

(207) 972-7005

Fax

(207) 973-8276

NPI assigned

Jun 3, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

Practice roles

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

• Norumbega Medical Specialists, LTD

  • Health Service Clinic/Center
  • Brewer, ME
  • NPI 1780821140
  NPD (past)
• Persona Neuro Behavior Group Inc.

  • Clinical Neuropsychologist
  • South Pasadena, CA
  • NPI 1881798171
  NPD (past)

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

{
    "created_epoch": "1149292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585785600000",
    "number": "1598703175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43 WHITING HILL RD STE 300",
            "city": "BREWER",
            "state": "ME",
            "postal_code": "044121006",
            "telephone_number": "207-973-8276"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "905 UNION ST STE 9",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044013039",
            "telephone_number": "207-972-7005",
            "fax_number": "207-973-8276"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CREECH",
        "first_name": "BONNIE",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-03",
        "last_updated": "2020-04-02",
        "certification_date": "2020-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "ME",
            "license": "PS1143",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tracy JH Crawford, LMT
• Creative Dental LLC
• Creative Dental Solutions LLC, P.a.
• Creative Options, LLC
• Creative Options, LLC
• Wanda J. Creed, BC-HIS
• Guillermo J Crespo, MD
• Cynthia Jeanine Crockett, PH.D.
• Jeremy Matthew Crockett, CADC
• Carmen Denise Crofoot, MD

• Clinical Neuropsychologist in Bangor, ME
• Providers in Bangor, ME by specialty
• Clinical Neuropsychologist in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2020; 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.