Kimberly Joy Cooper, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PS1486 Issued in ME

Practice address

895 Union St
Suite 12
Bangor, ME 04401-3053

Phone

(207) 973-7979

Fax

(207) 947-9579

NPI assigned

Nov 18, 2005

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

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, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kimberly.cooper@hawaiihie.medicity.net

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.

• Kimberly Cooper, PSYD PLLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Bangor, ME
  • NPI 1750059564
  Medicare reassignment NPD Authorized official
• Acadia Hospital Corp

  • Psychiatric Hospital
  • Bangor, ME
  • NPI 1215940523
  Medicare reassignment NPD

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

{
    "created_epoch": "1132272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585872000000",
    "number": "1598747032",
    "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": "207-973-5035",
            "fax_number": "207-973-5042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "895 UNION ST",
            "address_2": "SUITE 12",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044013053",
            "telephone_number": "207-973-7979",
            "fax_number": "207-947-9579"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOPER",
        "first_name": "KIMBERLY",
        "middle_name": "JOY",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-18",
        "last_updated": "2020-04-03",
        "certification_date": "2020-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "ME",
            "license": "PS1486",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daniel Patrick Conway, PA-C
• Katherine Page Conway, PA-C
• Philip Cook, D.O.
• Shannon Cook, PMH-NP
• Jillian E Cookson, MA CCC- SLP
• Courtney Rochelle Corbeil, DO
• Kenneth Wayne Corbin, R.P.H.
• Andrew Cordes
• Eric M Cormier, MSPT
• Cornerstone Behavioral Healthcare, LLC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2020; 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.