Psychodiagnostic Services of Southern Maine

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

Legal business name

PSYCHODIAGNOSTIC SERVICES OF SOUTHERN MAINE

Practice address

491 Stevens Ave
Portland, ME 04103-2636

Phone

(207) 828-4026

NPI assigned

Jun 3, 2008

Last updated

Jun 3, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Gregory CarboneNPI 1326215864

Title

Chief Officer

Phone

(207) 828-4026

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Gregory Carbone, PH.D.

  • Clinical Psychologist
  • Portland, ME
  • NPI 1326215864
  Authorized official Same address or phone

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

{
    "created_epoch": "1212451200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212451200000",
    "number": "1619136983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "491 STEVENS AVE",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041032636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "491 STEVENS AVE",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041032636",
            "telephone_number": "207-828-4026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PSYCHODIAGNOSTIC SERVICES OF SOUTHERN MAINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-03",
        "last_updated": "2008-06-03",
        "status": "A",
        "authorized_official_last_name": "CARBONE",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_title_or_position": "CHIEF OFFICER",
        "authorized_official_telephone_number": "207-828-4026"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gilda J Pronych, DDS
• Georgana Prudhomme, LCSW
• Rodger M. Pryzant, M.D.
• Psychiatric Associates
• Psychmaine LLC (PsychMaine)
• Paul Puchalski, LCSW
• Theresa Puckett
• Claire Zollman Puffer, PA-C
• Leah Puffer, RN
• Jennifer Pulas

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2008; 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.