Mary T Melquist, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PS1034 Issued in ME

Practice address

899 Riverside St
Portland, ME 04103-1070

Phone

(207) 871-1200

Fax

(207) 871-1232

NPI assigned

Mar 23, 2007

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1174608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493769600000",
    "number": "1700903804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "909 MIDDLE ST",
            "city": "BATH",
            "state": "ME",
            "postal_code": "045302450",
            "telephone_number": "207-615-5871"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "899 RIVERSIDE ST",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041031070",
            "telephone_number": "207-871-1200",
            "fax_number": "207-871-1232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MELQUIST",
        "first_name": "MARY",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-23",
        "last_updated": "2017-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "ME",
            "license": "PS1034",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Peter R Mellin, DDS
• Todd P Mellin, DMD
• Kaitlyn Beverly Mellon
• Joseph Melnick, PH.D.
• Spencer Melnick, L.C.S.W.
• Randall R Melvin, LCSW BCD
• Lilah Diane Melzer, DO
• Shaena Menagh
• Ashley K Mendes, LCSW
• Rolando Bryan Aberin Mendiola, PSY.D.

• 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 May 3, 2017; 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.