Active NPI
Elizabeth Brandt
- Clinical Psychologist
- Augusta, ME
National Provider Identifier
1639858640
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSYC.00015377
- Practice address
- 1 VA Ctr
Augusta, ME 04330-6795 - Phone
- (207) 623-8411
- NPI assigned
- Jul 17, 2023
- Sex
- Female
- Sole proprietor
- No
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 | PSYC.00015377 | CO | Primary |
Addresses
Primary practice location
1 VA Ctr
Augusta, ME 04330-6795
Mailing address
10 John Dr
North Grafton, MA 01536-1156
Phone (541) 221-5107
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSYC.00015377 | CO | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1689552000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1689552000000",
"number": "1639858640",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10 JOHN DR",
"city": "NORTH GRAFTON",
"state": "MA",
"postal_code": "015361156",
"telephone_number": "541-221-5107"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 VA CTR",
"city": "AUGUSTA",
"state": "ME",
"postal_code": "043306795",
"telephone_number": "207-623-8411"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRANDT",
"first_name": "ELIZABETH",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-07-17",
"last_updated": "2023-07-17",
"certification_date": "2023-07-17",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CO",
"license": "PSYC.00015377",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Augusta, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.