Active NPI
Linda Keil Wakely, PH.D.
- Clinical Psychologist
- Bangor, ME
National Provider Identifier
1598952913
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PS00519
- Practice address
- 6 State St
Suite 603
Bangor, ME 04401-5112 - Phone
- (207) 942-8085
- Fax
- (207) 942-5788
- NPI assigned
- Sep 30, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PS00519 | ME | Primary |
Addresses
Primary practice location
6 State St
Suite 603
Bangor, ME 04401-5112
Mailing address
6 State St
Suite 603
Bangor, ME 04401-5112
Phone (207) 942-8085
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
| License | State | Type | Specialty |
|---|---|---|---|
| PS00519 | ME | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1191110400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1191369600000",
"number": "1598952913",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6 STATE ST",
"address_2": "SUITE 603",
"city": "BANGOR",
"state": "ME",
"postal_code": "044015112",
"telephone_number": "207-942-8085",
"fax_number": "207-942-5788"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6 STATE ST",
"address_2": "SUITE 603",
"city": "BANGOR",
"state": "ME",
"postal_code": "044015112",
"telephone_number": "207-942-8085",
"fax_number": "207-942-5788"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WAKELY",
"first_name": "LINDA",
"middle_name": "KEIL",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-09-30",
"last_updated": "2007-10-03",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "ME",
"license": "PS00519",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bangor, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.