Active NPI
Carol Lynn C Kabacoff, PSY.D.
- Adult Development & Aging Psychologist
- South Portland, ME
National Provider Identifier
1669529376
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Development & Aging Psychologist
- License
- PS929
- Practice address
- 6 D St
South Portland, ME 04106-2820 - Phone
- (207) 321-0022
- Fax
- (207) 767-7002
- NPI assigned
- Jan 4, 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 6
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | PS929 | ME | |
| Adult Development & Aging Psychologist | 103TA0700X | PS929 | ME | Primary |
| Clinical Psychologist | 103TC0700X | PS929 | ME | |
| Clinical Child & Adolescent Psychologist | 103TC2200X | PS929 | ME | |
| Forensic Psychologist | 103TF0200X | PS929 | ME | |
| School Psychologist | 103TS0200X | PS929 | ME |
Addresses
Primary practice location
6 D St
South Portland, ME 04106-2820
Mailing address
6 D St
South Portland, ME 04106-2820
Phone (207) 321-0022
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 |
|---|---|---|---|
| PS929 | ME | MD | Clinical Child & Adolescent Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167868800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1757548800000",
"number": "1669529376",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6 D ST",
"city": "SOUTH PORTLAND",
"state": "ME",
"postal_code": "041062820",
"telephone_number": "207-321-0022",
"fax_number": "207-767-7002"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6 D ST",
"city": "SOUTH PORTLAND",
"state": "ME",
"postal_code": "041062820",
"telephone_number": "207-321-0022",
"fax_number": "207-767-7002"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KABACOFF",
"first_name": "CAROL LYNN",
"middle_name": "C",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-01-04",
"last_updated": "2025-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "ME",
"license": "PS929",
"primary": false
},
{
"code": "103TA0700X",
"taxonomy_group": "",
"desc": "Psychologist, Adult Development & Aging",
"state": "ME",
"license": "PS929",
"primary": true
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "ME",
"license": "PS929",
"primary": false
},
{
"code": "103TC2200X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical Child & Adolescent",
"state": "ME",
"license": "PS929",
"primary": false
},
{
"code": "103TF0200X",
"taxonomy_group": "",
"desc": "Psychologist, Forensic",
"state": "ME",
"license": "PS929",
"primary": false
},
{
"code": "103TS0200X",
"taxonomy_group": "",
"desc": "Psychologist, School",
"state": "ME",
"license": "PS929",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in South Portland, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.